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- W2023508386 abstract "Abstract Detailed hematologic studies were carried out on sixty-five consecutive patients admitted to the hospital because of alcoholism. Even though the patients were not selected for anemia, a striking incidence of hematologic abnormalities was found. Seventy-five per cent of the patients had a disorder of red cell production, most frequently megaloblastic erythropoiesis secondary to folic acid deficiency (40 per cent), or a ring sideroblastic defect of the marrow (30 per cent). Other causes of anemia, such as hemorrhage, infection or iron deficiency were far less common. The characteristics of the megaloblastic and sideroblastic abnormalities were defined by repeated studies during their first two weeks in the hospital and by research protocol studies on ten volunteer subjects. The latter included studies of subjects maintained for long periods on one of four protocols. These studies clearly demonstrate the rapidity of the appearance and disappearance of both megaloblastic and ring sideroblastic defects and the importance of variations in diet, vitamin and alcohol intake. The evolution of anemia in the alcoholic patient proceeds through predictable stages: (1) Negative vitamin balance—a stage which begins when the patient reduces his dietary intake and ingests significant amounts of alcohol. This period is characterized by a sharp fall in the serum folic acid level, with no abnormality in erythropoiesis; (2) megaloblastic conversion—which may occur as early as one week after initiating alcohol intake and a poor diet; (3) sideroblastic conversion—which may occur soon after the megaloblastic change and appears to be related either to pyridoxine deficiency or an intracellular enzyme defect; (4) early resolution—a recovery stage in which rapid disappearance of megaloblastic change with persistence of ring sideroblasts may make marrow interpretation difficult; (5) late resolution—in which marrow erythroid hyperplasia and reticulocytosis simulate a hemolytic state. Differences in timing of the medical evaluation rather than differences in etiology may yield any one of the five hematologic patterns in a given patient." @default.
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- W2023508386 date "1971-02-01" @default.
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- W2023508386 title "The evolution of anemia in alcoholic patients" @default.
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- W2023508386 doi "https://doi.org/10.1016/0002-9343(71)90151-3" @default.
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