December 1957, Vol 100, No. 6 >

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ARTICLE | December 1957

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. doi:10.1001/archinte.1957.00260120014003.

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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.^8,14,15The 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

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KRASNOW SE, WALSH JR, ZIMMERMAN HJ, HELLER P. Megaloblastic Anemia in "Alcoholic" Cirrhosis. AMA Arch Intern Med. 1957;100(6):870-880. doi:10.1001/archinte.1957.00260120014003.

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