The most characteristic manifestation of megaloblastic anaemia

The presence of red cells that are macrocytic and oval (macro-ovalocytes) is highly characteristic of megaloblastic anaemia.Other features are: Most macrocytes lack the central pallor of normal red cells and even appear "hyperchromic," but the MCHC is not elevated.The reticulocyte count is low. Nucleated red cell progenitors occasionally appear in the circulating blood when anaemia is severe. Neutrophils are also larger than normal (macro polymorphonuclear) and show nuclear hypersegmentation, having five or more nuclear lobules instead of the normal three to fourThe marrow is usually markedly hypercellular as a result of increased hematopoietic precursors, which often completely replace the fatty marrow. Megaloblastic changes are detected at all stages of erythroid development.Robbins 9e pg: 645