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Megaloblastic Anemia in "Alcoholic" Cirrhosis
SHELDON E. KRASNOW, M.D.;
JOHN R. WALSH, M.D.;
HYMAN J. ZIMMERMAN, M.D.;
PAUL HELLER, M.D.
AMA Arch Intern Med. 1957;100(6):870-880.
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Introduction
Macrocytic anemia is common in patients with hepatic disease.1-11 As early as 1883 an increase in the mean diameter of the erythrocyte was observed in "icterus catarrhalis."12 There have been numerous references 1-11 to this phenomenon, but its mechanism remains incompletely understood. Most investigators agree that this macrocytosis is not caused by a deficiency of the "hematopoietic principle" 13 and is not associated with megaloblastosis of the bone marrow.8,14,15
The most frequent abnormality of erythropoiesis in cirrhosis of the liver is normoblastic hyperplasia.8,14,15 It has been emphasized that this occurs even in the absence of bleeding and can be related to the shortened life span of the erythrocyte in this disease.16 Occasionally "macronormoblasts" 8 as large as megaloblasts are present in the bone marrow of cirrhotic patients, but these cells otherwise have morphological features typical of normoblasts. Nevertheless, megaloblastic anemia in patients with cirrhosis
. . . [Full Text PDF of this Article]
Author Affiliations
Chicago; Omaha; Chicago
From the Medical Services, Veterans' Administration West Side Hospital, Chicago, and Veterans' Administration Hospital, Omaha, and the Department of Medicine, University of Illinois College of Medicine.
Footnotes
Submitted for publication June 19, 1957.
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