Alkoholtoxische Veränderungen der Hämatopoiese

Abstract

In a prospective trial with 120 chronic alcoholics (July, 1978 to January, 1980) on admission the following haematological values significantly different from those of the normal population were found: elevated erythrocyte mean corpuscular volume (64%), increased mean corpuscular hemoglobin (32%), thrombocytopenia (48%), increased percentage of bone marrow sideroblasts (35%), decreased percentage of sideroblasts (37%), megaloblastic bone marrow changes (55%) including nuclear abnormalities (32%), and vacuolization in red cell (20%) and white cell (16%) precursors. These changes were independent of liver cirrhosis with hypersplenism (increased mean corpuscular volume in 52% of the patients who did not have liver cirrhosis, increased mean corpuscular volume in 76% of the patients who were cirrhotic but not suffering from major bleeding). Platelets returned to normal values within 6 days of discontinuation of alcohol ingestion. In respect to iron metabolism we found the following changes: decreased serum iron concentration (32%), increased iron concentration (42%), increased total iron binding capacity (54%), increased ferritin (41%), decreased transferrin (20%). In contrast to data from the Anglo-American literature, serum folate concentrations were mostly normal in our patients (87%). This may be due to different eating and drinking habits. The percentage of bone marrow sideroblasts was also lower in our patients than those described in the literature mentioned above. The changes in maturation are likely to be caused partially by a toxic effect of alcohol on nuclear metabolism of bone marrow cells.

Erythrocyte Mean Cell Volume—Correlation to Drinking Pattern in Heavy Alcoholics

“…In alcoholism, the larger erythrocytes are likely to be caused partly by a toxic effect of alcohol on the haemopoiesis leading to megaloblastic changes, especially vacuolization and nuclear abnormalities (16). Bone marrow cells are normalized a few days after alcohol withdrawal (17, 18).…”

Alcohol-Induced Bone Marrow Damage

“…In common with Heideman et al [6] and Schulz and Sanft [19], we interpret an increased megakaryocyte count in bone marrow prepartions as a sign of heightened, ineffective thrombocytopoiesis.…”

“…Our patients were for the most part beer drink ers. Beer has a relatively high folic acid content, hence beer-drinking alcoholics are seldom if ever deficient in folic acid, whereas malnourished patients and alco holics who drink wine and spirits do suffer from folic acid deficiency [4,10,12], However, some authors have failed to find a correlation between different types of alcoholic drinks and serum folic acid levels [1,6], while others have claimed that alcohol has an antifolate effect [5,12]. The serum vitamin B12 levels of our 30 patients were not outside the normal range.…”

“…This finding is evidence of defective red cell production associated with impaired iron utiliza tion. Heidemann et al [6] as well as Schulz and Sanft [19] have also described defective red cell production in alcoholics.…”

Alcohol abuse and Streptococcus pneumoniae infections: consideration of virulence factors and impaired immune responses

“…Chronic alcohol abuse is frequently associated with leukopenia particularly granulocytopenia (Seppa et al, 1993). Reduction in the number of mature granulocytes with vacuolization of myeloid progenitor cells is observed in the bone marrow analysis of chronic alcohol abusers (Heidemann et al, 1981). The suppression of G-CSF in response to alcohol exposure has also been validated in animal models.…”