Peripheral Blood and Bone Marrow Findings in Chronic Alcoholics with Special Reference to Acquired Sideroblastic Anemia

Abstract

Anemia associated with alcoholism has numerous causes, most common being megaloblastic anemia and acquired sideroblastic anemia (SA). The bone marrow aspirate (BMA) and bone marrow iron (BMIr) findings and their correlation with peripheral blood smear (PBS) have not been extensively described in literature. We aim to study the spectrum of hematological abnormalities in chronic alcoholics. Complete blood count (CBC), PBS, BMA and BMIr of 71 chronic alcoholics were studied retrospectively over a period of 3 years. The slides were reviewed by 2 pathologists. The clinical history, CBC, PBS, BMA and BMIr findings were recorded. Out of 71 patients, 68 (95.77%) had anaemia. Red cell morphology varied from normocytic-normochromic, microcytic-hypochromic, macrocytic, to dimorphic anaemia. Principal findings seen on BMA were erythroid hyperplasia and megaloblastic maturation. BMIr was available in 41 patients; iron stores were decreased in 2 (4.88%), normal in 14 (34.15%), increased in 25 (60.97%). Seven (17.07%) cases showed presence of ring sideroblasts. Chronic alcoholics show a variety of abnormalities in BMA, which closely mimic many haematological disorders. A history of alcoholism should always be taken in these circumstances. SA should be ruled out in all chronic alcoholics with anaemia not responding to vitamin B12/folic acid, even with macrocytic picture on PBS.

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Abbreviations

PBS:

Peripheral blood smear

SA:

Sideroblastic anemia

BMA:

Bone marrow aspiration

BMIr:

Bone marrow iron

Hct:

Hematocrit

MCV:

Mean corpuscular volume

MCH:

Mean corpuscular hemoglobin

MCHC:

Mean corpuscular hemoglobin concentration

MDS:

Myelodysplastic syndrome

CBC:

Complete blood count

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Correspondence to Mrinalini Kotru.

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Mangla, G., Garg, N., Bansal, D. et al. Peripheral Blood and Bone Marrow Findings in Chronic Alcoholics with Special Reference to Acquired Sideroblastic Anemia. Indian J Hematol Blood Transfus 36, 559–564 (2020). https://doi.org/10.1007/s12288-019-01188-5

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Keywords

  • Chronic alcoholics
  • Ring sideroblasts
  • Peripheral blood smear
  • Bone marrow aspirate
  • Acquired sideroblastic anemia
  • Bone marrow iron