- With Mayo Clinic hematologist
Ruben A. Mesa, M.D.
read biographyclose windowBiography of
Ruben A. Mesa, M.D.
Ruben A. Mesa, M.D.
Dr. Ruben Mesa is board certified in internal medicine, hematology and medical oncology and is director of the Acute and Chronic Leukemias Program in the Division of Hematology-Oncology at Mayo Clinic in Arizona. Dr. Mesa is also a professor of medicine.
The Chicago-area native's primary field of interest is hematology with special interests in both acute and chronic leukemias — specifically the chronic myeloproliferative disorders (MPDs).
"I believe patients' understanding of their disease is a critical first step in the healing process," he says. "I believe that the Internet, carefully used, is a phenomenal resource for patients to be able to access high-quality and valuable information to understand both their diseases and various treatments."
Dr. Mesa has been with Mayo Clinic throughout his training since 1991 and is a graduate of Mayo Medical School. He is a member of the American Society of Hematology, the American Society of Clinical Oncology and the American College of Physicians.
His scholarship has focused on advancing the understanding and therapy of the chronic myeloproliferative disorders. In these disorders, he has been active in evaluating novel therapeutics, implementing clinical trials, and working with quality of life studies. He also works with national patient groups.
He has been principal investigator or co-principal investigator in 20 clinical trials for patients with myeloproliferative neoplasms or other myeloid disorders. He is committed to improving the therapy and quality of life in MPD patients. He has lectured both nationally and internationally on these disorders.
Dr. Mesa founded the biennial Mayo Clinic Living With a Blood Disease Symposium for patients with hematologic diseases. He sits on the editorial board of the journal Blood, and several other journals.
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Question
Macrocytosis: What causes it?
What causes enlarged red blood cells (macrocytosis)?
Answer
from Ruben A. Mesa, M.D.
Macrocytosis is a term used to describe red blood cells that are larger than normal. It typically causes no signs or symptoms and is usually detected incidentally on routine blood tests.
Macrocytosis isn't a specific disease, but it may indicate an underlying problem that requires medical evaluation. Common causes of macrocytosis include:
- Vitamin B-12 deficiency
- Folate deficiency
- Liver disease
- Alcoholism
- Hypothyroidism
- A side effect of certain medications, such as those used to treat cancer, seizures and autoimmune disorders
- Increased red blood cell production by the bone marrow (regeneration) to correct anemia, for example, after blood loss
If you have macrocytosis, blood tests can help determine its cause. In some cases, it may be necessary to remove a sample of your bone marrow — the spongy tissue inside your bones — for testing (bone marrow biopsy and aspiration).
Treatment of macrocytosis, if needed, is directed at the underlying cause. In the case of vitamin B-12 or folate deficiency, for instance, treatment may include diet modification and dietary supplements or injections. If macrocytosis is caused by severe anemia, a blood transfusion might be necessary.
- Kaferle J, et al. Evaluation of macrocytosis. American Family Physician. 2009;79:203.
- Schrier SL, et al. Macrocytosis. http://www.uptodate.com/home/index.html. Accessed Feb. 1, 2012.
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