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• W2035699049 abstract "A moderate anemia due chiefly to reduction of red blood cell count with a modest reduction in MCHC is common in rheumatoid arthritis and contributes to the disability and morbidity produced by the disease. This anemia has features in common with that found in other chronic disease states, and its cause is multifactorial. Mild degrees of hemodilution and hemolysis occur, and there is some impairment of iron absorption from the gastrointestinal tract. Blood loss from the gastrointestinal tract is probably not important in most cases. More important causes are the abnormal storage of iron in the reticuloendothelial system and synovial tissue and the failure of bone marrow to respond to anemia. Most of these abnormalities are related to the activity of the disease and return to normal when this is controlled. Interest has been expressed in the possible cause of iron storage in the synovial tissue and whether the iron has any local action. It is yet undetermined whether iron enters the synovial cells by an active or passive process and whether it has a local action on lysosomal membranes. It is possible that iron has a beneficial effect by acting in a manner similar to gold, but the effect of iron on lysosomal systems requires investigation. The possibility of megaloblastic anemia in rheumatoid arthritis must always be borne in mind, especially in those cases in which the degree of anemia is not proportional to the activity of the disease. Further population surveys are required to establish the true incidence of pernicious anemia in association with rheumatoid arthritis, but these are time-consuming because multiple investigations of vitamin B12 metabolism are required. Although folate deficiency is apparently common in rheumatoid arthritis on the basis of serum folate values, it requires bone marrow examination and erythrocyte folate values for its true diagnosis. The latter is not yet a routine laboratory procedure. Although many of the abnormalities in folate metabolism return to normal when the activity of the disease is controlled, some patients will require folate supplements on a long-term basis. Many of the pathways of folate metabolism in patients with rheumatoid arthritis, particularly with regard to dietary requirements, cell proliferation, protein abnormalities, and deficiency of iron and pyridoxine, require further investigation. The existence of Felty's syndrome as a distinct disease entity has been questioned, and the value of splenectomy in this disease has been examined. More detailed reports of the effect of splenectomy on the incidence of bacterial infection are required. It is suggested that in these patients greater attention be directed toward the measurement of white cell function than toward actual white cell count." @default.
• W2035699049 created "2016-06-24" @default.
• W2035699049 creator A5017310167 @default.
• W2035699049 date "1972-12-01" @default.
• W2035699049 modified "2023-10-16" @default.
• W2035699049 title "Hematologic abnormalities in rheumatoid arthritis" @default.
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• W2035699049 doi "https://doi.org/10.1016/0049-0172(72)90001-7" @default.
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