 There are several instances where an homocytic picture could deceive one into thinking that there is no abnormality in cytoplasmic maturation or nuclear maturation. And one of these instances is when you have had immune hemolysis. There is a strong reticulocytic response to an immune hemolysis, generating very large reticulocytes. And when you have increased numbers of these reticulocytes, then when you add up all the cells, although the majority are macrositic or nomocytic, these macrosites are not enough to give you a high MCV. The MCV remains within normal, but one needs to bear this in mind and look at the red cell distribution curve. The distribution curve will show telltale signs of a tail towards the larger cells. That will be the key and the reason for suspecting that there are a few large cells that are pushing the average to within normal. And it will only be a number, a question of time before you see a high MCV.