Skip to main content

Metabolic Effects of Alcohol on the Blood and Bone Marrow

  • Chapter
Metabolic Aspects of Alcoholism

Abstract

It has been increasingly recognized that a kaleidoscopic variety of haematological complications may occur in alcoholic patients. Often it has been difficult to disentangle the relative roles of liver disease, infection, malnutrition, and alcohol ingestion in their pathogenesis. Considerable progress has been made in recent years in delineating the importance of ethanol itself as a haematological toxin. Syndromes which were not even recognized 10 years ago, such as alcohol-induced thrombocytopenia or alcohol-induced sideroblastic anaemia, have been well characterized clinically, reproduced experimentally in human volunteers, and at least partially defined in terms of physiological mechanisms. Other haematological derangements have been identified but remain poorly understood. This chapter will review the current state of knowledge of the various disorders of alcoholics affecting red cells, platelets, and white cells.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Jarrold, T. and Vilter, R. W. (1949). Hematologic observations in patients with chronic hepatic insufficiency: sternal bone marrow morphology and bone marrow plasmacytosis. J. Clin. Invest., 28, 286

    Google Scholar 

  2. Movitt, E. R. (1949). Megaloblastic bone marrow in liver disease. Am. J. Med., 7, 145

    PubMed  CAS  Google Scholar 

  3. Movitt, E. R. (1950). Megaloblastic erythropoiesis in patients with cirrhosis of the liver. Blood, 5, 468

    PubMed  CAS  Google Scholar 

  4. Jandl, J. H. (1955). Anemia of liver disease: observations on its mechanism. J. Clin. Invest., 34, 390

    PubMed  CAS  Google Scholar 

  5. Jandl, J. H. and Lear, A. A. (1956). The metabolism of folic acid in cirrhosis. Ann. Intern. Med., 45, 1027

    PubMed  CAS  Google Scholar 

  6. Krasnow, S., Walsh, J. R., Zimmerman, H. and Heller, P. (1957). Megaloblastic anemia in ‘alcoholic’ cirrhosis. Arch. Intern. Med., 100, 870

    CAS  Google Scholar 

  7. Herbert, V., Baker, H., Frank, O., Pasher, I., Sobotka, H. and Wasserman, L. R. (1960). The measurement of folic acid activity in serum: a diagnostic acid in the differentiation of the megaloblastic anemias. Blood, 15, 228

    PubMed  CAS  Google Scholar 

  8. Herbert, V., Zalusky, R. and Davidson, C. S. (1963). Correlation of folate deficiency with alcoholism and associated macrocytosis, anemia, and liver disease. Ann. Intern. Med., 58, 977

    PubMed  CAS  Google Scholar 

  9. Klipstein, F. A. and Lindenbaum, J. (1965). Folate deficiency in chronic liver disease. Blood, 25, 443

    PubMed  CAS  Google Scholar 

  10. Deller, D. J., Kimber, C. L. and Ibbotson, R. N. (1965). Folic acid deficiency in cirrhosis of the liver. Am. J. Dig. Dis., 10, 35

    PubMed  CAS  Google Scholar 

  11. Kimber, C. L., Deller, D. J. and Lander, H. (1965). Megaloblastic and transitional megaloblastic anemia associated with chronic liver disease. Am. J. Med., 38, 767

    PubMed  CAS  Google Scholar 

  12. Jarrold, T., Will, J. J., Davies, A. R., Duffy, P. H. and Bramschreiber, B. L. (1967). Bone marrow-erythroid morphology in alcoholic patients. Am. J. Clin. Nutr., 20, 716

    PubMed  CAS  Google Scholar 

  13. Hines, J. D. (1969). Reversible megaloblastic and sideroblastic marrow abnormalities in alcoholic patients. Br. J. Haematol., 16, 87

    PubMed  CAS  Google Scholar 

  14. Eichner, E. R. and Hillman, R. S. (1971). The evolution of anemia in alcoholic patients. Am. J. Med., 50, 218

    PubMed  CAS  Google Scholar 

  15. Cowan, D. H. and Hines, J. D. (1971). Thrombocytopenia of severe alcoholism. Ann. Intern. Med., 74, 37

    PubMed  CAS  Google Scholar 

  16. Williams, I. R. and Girdwood, R. H. (1970). The folate status of alcoholics. Scot. Med. J., 15, 285

    PubMed  CAS  Google Scholar 

  17. Hourihane, C. O. and Weir, D. G. (1970). Suppression of erythropoiesis by alcohol. Br. Med. J., i, 86

    Google Scholar 

  18. Eichner, E. R., Buchanan, B., Smith, J. W. and Hillman, R. S. (1972). Variations in the hematologic and medical status of alcoholics. Am. J. Med., 263, 35

    CAS  Google Scholar 

  19. Lindenbaum, J. Unpublished observations

    Google Scholar 

  20. Herbert, V. (1963). A palatable diet for producing experimental folate deficiency in man. Am. J. Clin. Nutr., 12, 17

    PubMed  CAS  Google Scholar 

  21. Herbert, V. (1962). The diagnosis and treatment of folic acid deficiency. Med. Clin. N. Am., 46, 1365

    PubMed  CAS  Google Scholar 

  22. Herbert, V. (1963). Current concepts in therapy: megaloblastic anemia. N. Engl. J. Med., 268, 201

    PubMed  CAS  Google Scholar 

  23. Herbert, V. (1962). Experimental nutritional folate deficiency in man. Trans. Ass. Am. Phys., 75, 307

    CAS  Google Scholar 

  24. Herbert, V. (1962). Minimal daily adult folate requirement. Arch. Intern. Med., 110, 649

    PubMed  CAS  Google Scholar 

  25. Eichner, E. R., Pierce, H. I. and Hillman, R. S. (1971). Folate balance in dietary-induced megaloblastic anemia. N. Engl. J. Med., 284, 933

    PubMed  CAS  Google Scholar 

  26. Sullivan, L. W. and Herbert, V. (1964). Suppression of hematopoiesis by ethanol. J. Clin. Invest., 43, 2048

    PubMed  CAS  Google Scholar 

  27. Hines, J. D. and Cowan, D. H. (1970). Studies on the pathogenesis of alcohol-induced sideroblastic bone-marrow abnormalities. N. Engl. J. Med., 283, 441

    PubMed  CAS  Google Scholar 

  28. Eichner, E. R. and Hillman, R. S. (1973). Effect of alcohol on serum folate level. J. Clin. Invest., 52, 584

    PubMed  CAS  Google Scholar 

  29. Cowan, D. H. (1973). Thrombokinetic studies in alcohol-related thrombocytopenia. J. Lab. Clin. Med., 81, 64

    PubMed  CAS  Google Scholar 

  30. Lindenbaum, J. and Lieber, C. S. (1969). Hematologic effects of alcohol in man in the absence of nutritional deficiency. N. Engl. J. Med., 281, 333

    PubMed  CAS  Google Scholar 

  31. Halsted, C. H., Robles, E. A. and Mezey, E. (1971). Decreased jejunal uptake of labeled folic acid (3H-PGA) in alcoholic patients: roles of alcohol and nutrition. N. Engl. J. Med., 285, 701

    PubMed  CAS  Google Scholar 

  32. Halsted, C. H., Robles, E. A. and Mezey, E. (1973). Intestinal malabsorption in folatedeficient alcoholics. Gastroenterology, 64, 526

    PubMed  CAS  Google Scholar 

  33. Hermos, J. A., Adams, W. H., Liu, Y. K., Sullivan, L. W. and Trier, J. S. (1972). Mucosa of the small intestine in folate-deficient alcoholics. Ann. Intern. Med., 76, 957

    PubMed  CAS  Google Scholar 

  34. Lindenbaum, J. and Pezzimenti, J. F. (1972). Effects of B12 and folate deficiency on small intestinal function. Clin. Res., 20, 871

    Google Scholar 

  35. Paine, C. J., Eichner, E. R. and Dickson, V. (1973). Concordance of radioassay and microbiological assay in the study of the ethanol-induced fall in serum folate level. Am. J. Med. Sci., 266, 135

    CAS  Google Scholar 

  36. Lane, F., Goff, P., McGuffin, R. and Hillman, R. (1973). The influence of ethanol on folate metabolism. Blood, 42, 998

    Google Scholar 

  37. Bertino, J. R., Ward, J., Sartorelli, A. C. and Silber, R. (1965). An effect of ethanol on folate metabolism. J. Clin. Invest., 44, 1028

    Google Scholar 

  38. Trau, N., Laplante, M. and Lebel, E. (1972). Abnormal oxidation of [14C]formaldehyde to 14CO2 in erythrocytes of alcoholics and nonalcoholics after consumption of alcoholic beverages. J. Nucl. Med., 13, 677

    Google Scholar 

  39. Greene, H. L., Stifel, F. B., Herman, R. H., Herman, Y. F. and Rosensweig, N. S. (1974). Ethanol-induced inhibition of human intestinal enzyme activities: reversal by folic acid. Gastroenterology, 67, 434

    PubMed  CAS  Google Scholar 

  40. Cherrick, G. R., Baker, H., Frank, O. and Leevy, C. M. (1965). Observations on hepatic avidity for folate in Laennec’s cirrhosis. J. Lab. Clin. Med., 66, 6

    Google Scholar 

  41. Retief, E. P. and Huskisson, Y. J. (1969). Serum and urinary folate in liver disease. Br. Med. J., ii, 150

    Google Scholar 

  42. Hines, J. D. and Grasso, J. A. (1970). The sideroblastic anemias. Sem. Hematol., 7, 86

    CAS  Google Scholar 

  43. Hines, J. D. and Cowan, D. H. (1974). Anemia in alcoholism. In N. V. Dimitrov and J. H. Nodine, eds. Drugs and Hematologic Reactions, p. 141. New York: Grune and Stratton

    Google Scholar 

  44. Grasso, J. A. and Hines, J. D. (1969). A comparative electron microscopic study of refractory and alcoholic sideroblastic anemia. Br. J. Haematol., 17, 34

    Google Scholar 

  45. Ali, M. A. M. and Sweeney, G. (1974). Erythrocyte coproporphyrin and protoporphyrin in ethanol-induced sideroblastic erythropoiesis. Blood, 43, 291

    PubMed  CAS  Google Scholar 

  46. Waters, A. H., Morley, A. A. and Rankin, J. G. (1966). Effect of alcohol on haemopoiesis. Br. Med. J., ii, 1565

    Google Scholar 

  47. Aoki, Y., Urata, G., Wada, O. and Takaku, F. (1974). Measurement of δ-aminolevulinic acid synthetase activity in human erythroblasts. J. Clin. Invest., 53, 1326

    PubMed  CAS  Google Scholar 

  48. Leevy, C. M., Baker, H., tenHove, W., Frank, O. and Cherrick, G. R. (1965). B-complex vitamins in liver disease of the alcoholic. Am. J. Clin. Nutr., 16, 339

    PubMed  CAS  Google Scholar 

  49. Hines, J. D. and Love, D. S. (1969). Determination of serum and blood pyridoxal phosphate concentrations with purified rabbit skeletal muscle apophosphorylase b. J. Lab. Clin. Med., 73, 343

    PubMed  CAS  Google Scholar 

  50. Hines, J. D. (1973). Alcohol-induced abnormalities in the metabolism of vitamin B6 in humans. Proc. First Ann. Alcoholism Conf. of NIAAA, Washington, D.C., p. 6.

    Google Scholar 

  51. Lumeng, L. and Li, T. (1974). Vitamin B6 metabolism in chronic alcohol abuse. J. Clin. Invest., 53, 693

    PubMed  CAS  Google Scholar 

  52. Frank, O., Luisada-Opper, A., Sorrell, M. F., Thomson, A. D. and Baker, H. (1971). Vitamin deficits in severe alcoholic fatty liver of man calculated from multiple reference units. Exper. Molec. Pathol., 15, 191

    CAS  Google Scholar 

  53. Veitch, R. L., Lumeng, L. and Li, T. K. (1974). The effect of ethanol and acetaldehyde on vitamin B6 metabolism in liver. Gastroenterology, 66, 868

    Google Scholar 

  54. Krasner, N., Moore, M. R., Thompson, G. G., Mcintosh, W. and Goldberg, A. (1974). Depression of erythrocyte δ-aminolaevulinic acid dehydratase activity in alcoholics. Clin. Sci. Molec. Med., 46, 415

    CAS  Google Scholar 

  55. Rubin, E., Beattie, D. S., Toth, A. and Lieber, C. S. (1972). Structural and functional effects of ethanol on hepatic mitochondria. Fed. Proc., 31, 131

    PubMed  CAS  Google Scholar 

  56. Neame, P. B. and Beck, I. (1970). Recurrent alcoholic sideroblastosis and hepatic hemosiderosis. N. Engl. J. Med., 283, 1173

    PubMed  CAS  Google Scholar 

  57. McCurdy, P. R., Pierce, L. E. and Rath, C. E. (1962). Abnormal bone marrow morphology in acute alcoholism. N. Engl. J. Med., 266, 505

    Google Scholar 

  58. Lindenbaum, J. and Hargrove, R. L. (1968). Thrombocytopenia in alcoholics. Ann. Intern. Med., 68, 526

    PubMed  CAS  Google Scholar 

  59. Lopez, R. and Montoya, M. F. (1971). Abnormal bone marrow morphology in the premature infant associated with maternal alcohol infusion. J. Pediat., 79, 1008

    PubMed  CAS  Google Scholar 

  60. Yeung, K. Y., Klug, P. P., Brower, M. and Lessin, L. S. (1973). Mechanism of alcoholinduced vacuolization in human bone marrow cells. Blood, 42, 998

    Google Scholar 

  61. Lehane, D. E. (1974). Vacuolated erythroblasts in hyperosmolar coma. Arch. Intern. Med., 134, 763

    PubMed  CAS  Google Scholar 

  62. Lindenbaum, J. (1974). Hematologic effects of alcohol. In B. Kissin and H. Begleiter, eds. The Biology of Alcoholism, Volume 3, Clinical Pathology, p. 461. New York: Plenum Press

    Google Scholar 

  63. Subhiyah, B. W. and Al-Hindawi, A. Y. (1967). Red cell survival and splenic accumulation of radiochromium in liver cirrhosis with splenomegaly. Br. J. Haematol., 13, 773

    PubMed  CAS  Google Scholar 

  64. Hall, C. A. (1960). Erythrocyte dynamics in liver disease. Am. J. Med., 28, 541

    PubMed  CAS  Google Scholar 

  65. Kimber, C., Deller, D. J., Ibbotson, R. N. and Lander, H. (1965). The mechanism of anemia in chronic liver disease. Q. J. Med., 34, 33

    PubMed  CAS  Google Scholar 

  66. Cartwright, G. E. (1966). Anemia of chronic disorders. Semin. Hematol., 3, 351

    PubMed  CAS  Google Scholar 

  67. Felsher, B. F., Redeker, A. G. and Reynolds, T. B. (1968). Indirect reacting hyperbilirubinemia in cirrhosis: its relation to red cell survival. Am. J. Dig. Dis., 13, 598

    PubMed  CAS  Google Scholar 

  68. Hume, R., Williamson, J. M. and Whitelaw, J. W. (1970). Red cell survival in biliary cirrhosis. J. Clin. Pathol., 23, 297

    Google Scholar 

  69. Bingham, J. (1958). The macrocytosis of hepatic disease. I. Thin macrocytosis. Blood, 14,

    Google Scholar 

  70. Bingham, J. (1960). The macrocytosis of hepatic disease. II. Thick macrocytosis. Blood, 15, 244

    PubMed  CAS  Google Scholar 

  71. Bingham, J. R. (1961). The macrocytosis of hepatic disease: thin, thick and target macrocytosis. Can. Med. Ass. J., 85, 178

    PubMed  CAS  Google Scholar 

  72. Berman, L., Axelrod, A. R., Horan, T. N., Jacobson, S. D., Sharp, E. A. and VonderHeide, E. C. (1949). The blood and bone marrow in patients with cirrhosis of the liver. Blood, 4, 511

    PubMed  CAS  Google Scholar 

  73. Kilbridge, T. M. and Heller, P. (1969). Determinants of erythrocyte size in chronic liver disease. Blood, 34, 739

    PubMed  CAS  Google Scholar 

  74. Wu, A., Chanarin, I. and Levi, A. J. (1974). Macrocytosis of chronic alcoholism. Lancet, i, 829

    Google Scholar 

  75. Unger, K. W. and Johnson, D., Jr. (1974). Red blood cell mean corpuscular volume: a potential indicator of alcohol usage in a working population. Med. Sci., 267, 281

    CAS  Google Scholar 

  76. Werre, J. M., Helleman, P. W., Verloop, M. C. and de Gier, J. (1970). Causes of macroplania of erythrocytes in diseases of the liver and biliary tract with special reference to leptocytosis. Br. J. Haematol., 19, 223

    PubMed  CAS  Google Scholar 

  77. Neerhout, R. C. (1968). Abnormalities of erythrocyte stromal lipids in hepatic disease. J. Lab. Clin. Med., 71, 438

    PubMed  CAS  Google Scholar 

  78. Cooper, R. A., Diloy-Puray, M., Lando, P. and Greenberg, M. S. (1972). An analysis of lipoproteins, bile acids, and red cell membranes associated with target cells and spur cells in patients with liver disease. J. Clin. Invest., 51, 3182

    PubMed  CAS  Google Scholar 

  79. Neerhout, R. C. (1968). Reversibility of the erythrocyte lipid abnormalities in hepatic disease. J. Pediat., 73, 364

    PubMed  CAS  Google Scholar 

  80. Cooper, R. A. and Jandl, J. H. (1968). Bile salts and cholesterol in the pathogenesis of target cells in obstructive jaundice. J. Clin. Invest., 47, 809

    PubMed  CAS  Google Scholar 

  81. Smith, J. A., Lonergan, E. T. and Sterling, K. (1965). Spur-cell anemia: hemolytic anemia with red cells resembling acanthocytes in alcoholic cirrhosis. N. Engl. J. Med., 271, 396

    Google Scholar 

  82. Silber, R., Amorosi, E., Lhowe, J. and Kayden, H. J. (1966). Spur-shaped erythrocytes in Laennec’s cirrhosis. N. Engl. J. Med., 275, 639

    PubMed  CAS  Google Scholar 

  83. Grahn, E. P., Dietz, A. A., Stefani, S. S. and Donnelly, W. J. (1968). Burr cells, hemolytic anemia and cirrhosis. Am. J. Med., 45, 78

    PubMed  CAS  Google Scholar 

  84. Cooper, R. A. (1969). Anemia with spur cells: a red cell defect acquired in serum and modified in the circulation. J. Clin. Invest., 48, 1820

    PubMed  CAS  Google Scholar 

  85. Douglass, C. G., McCall, M. S. and Frenkel, E. P. (1968). The acanthocyte in cirrhosis with hemolytic anemia. Ann. Intern. Med., 68, 390

    PubMed  CAS  Google Scholar 

  86. McBride, J. A. and Jacob, H. S. (1970). Abnormal kinetics of red cell membrane cholesterol in acanthocytes: studies in genetic and experimental abetalipoproteinaemia and in spur cell anaemia. Br. J. Haematol., 18, 383

    PubMed  CAS  Google Scholar 

  87. Martinez-Maldonado, M. (1968). Role of lipoproteins in the formation of spur cell anaemia. J. Clin. Path., 21, 620

    PubMed  CAS  Google Scholar 

  88. Cooper, R. A., Kimball, D. B. and Durocher, J. R. (1974). Role of the spleen in membrane conditioning and hemolysis of spur cells in liver disease. N. Engl. J. Med., 290, 1279

    PubMed  CAS  Google Scholar 

  89. Tchernia, G., Navarro, J., Becart, R. and Casasoprana, A. (1968). Anémie hémolytique avec acanthocytose et dyslipidémie au cours de deux hépatites néonates. Arch. Franc. Pédiat., 25, 729

    PubMed  CAS  Google Scholar 

  90. Marie, J., Fleury, F., Hennequet, A., Cloup, M. and Watchi, J.-M. (1967). Ictère grave cirrhogène avec acanthocytose chez le nourrisson. Arch. Franc. Pédiat., 24, 585

    Google Scholar 

  91. Keller, J. W., Majerus, P. W. and Finke, E. H. (1971). An unusual type of spiculated erythrocyte in metastatic liver disease and hemolytic anemia. Ann. Intern. Med., 74, 732

    PubMed  CAS  Google Scholar 

  92. Turpin, F., Vaugier, G., Bécart-Nichel, R. and Binet, J. L. (1971). Acanthocytose dans un cas de cirrhose alcoolique avec anémie. Transformation en acanthocytes de globules rouges transfusés. Nouvelle Rev. Franc. Hématol., 11:, 791

    CAS  Google Scholar 

  93. Brecher, G. and Bessis, M. (1972). Present status of spiculed red cells and their relationship to the discocyte-echinocyte transformation: a critical review. Blood, 40, 333

    PubMed  CAS  Google Scholar 

  94. Shohet, S. B. (1974). ‘Acanthocytogenesis’—or how the red cell won its spurs. N. Engl. J. Med., 290, 1316

    PubMed  CAS  Google Scholar 

  95. Zieve, L. (1958). Jaundice, hyperlipemia and hemolytic anemia: a heretofore unrecognized syndrome associated with alcoholic fatty liver and cirrhosis. Ann. Intern. Med., 48, 471

    PubMed  CAS  Google Scholar 

  96. Kessel, L. (1962). Acute transient hyperlipemia due to hepatopancreatic damage in chronic alcoholics (Zieve’s syndrome). Am. J. Med., 32, 747

    PubMed  CAS  Google Scholar 

  97. Blass, J. P. and Dean, H. M. (1966). The relation of hyperlipemia to hemolytic anemia in an alcoholic patient. Am. J. Med., 40, 283

    Google Scholar 

  98. Balcerzak, S. P., Westerman, M. P. and Heinle, E. W. (1968). Mechanism of anemia in Zieve’s syndrome. Am. J. Med., 225, 277

    Google Scholar 

  99. Gadrat, J., Douste-Blazy, L., Ribet, A., Pascal, J. P. and Frexinos, J. (1967). Syndrome de Zieve associé a une pancréatite calcifiante. Presse Med., 75, 789

    PubMed  CAS  Google Scholar 

  100. Albahary, C., Auffret, M. and Le Gland, J. L. (1968). Syndrome de Zieve, hyperlipidémie alcoolique et anémie hémolytique. Presse Med., 76, 371

    PubMed  CAS  Google Scholar 

  101. Zieve, L. (1966). Hemolytic anemia in liver disease. Medicine, 45, 497

    PubMed  CAS  Google Scholar 

  102. Eichner, E. R. (1973). The hematologic disorders of alcoholism. Am. J. Med., 54, 621

    PubMed  CAS  Google Scholar 

  103. Douglass, C. C. and Twomey, J. J. (1970). Transient stomatocytosis with hemolysis: a previously unrecognized complication of alcoholism. Ann. Intern. Med., 72, 159

    PubMed  CAS  Google Scholar 

  104. Zarkowsky, H. S., Oski, F. A., Sha’afi, R. et al. (1968). Congenital hemolytic anemia with high sodium, low potassium red cells. I. Studies of membrane permeability. N. Engl. J. Med., 278, 573

    PubMed  CAS  Google Scholar 

  105. Oski, F. A., Naiman, J. L., Blum, S. F. et al. (1969). Congenital hemolytic anemia with high-sodium, low-potassium red cells. N. Engl. J. Med., 280, 909

    PubMed  CAS  Google Scholar 

  106. Coste, T., Gouffier, C. E. and Paraf, A. (1972). Les troubles hématologiques de l’alcoolisme aigu. Sem. Hôp. Paris, 48, 2427

    PubMed  CAS  Google Scholar 

  107. Jacob, H. S. and Amsden, T. (1971). Acute hemolytic anemia with rigid red cells in hypophosphatemia. N. Engl. J. Med., 285, 1446

    PubMed  CAS  Google Scholar 

  108. Klock, J. C., Williams, H. E. and Mentzer, W. C. (1974). Hemolytic anemia and somatic cell dysfunction in severe hypophosphatemia. Arch. Intern. Med., 134, 360

    PubMed  CAS  Google Scholar 

  109. Territo, M. C. and Tanaka, K. R. (1974). Hypophosphatemia in chronic alcoholism. Arch. Intern. Med., 134, 445

    PubMed  CAS  Google Scholar 

  110. Sheehy, R. W. and Berman, A. (1954). The anemia of cirrhosis. J. Lab. Clin. Med., 56, 72

    Google Scholar 

  111. Perera, G. A. (1946). The plasma volume in Laennec’s cirrhosis of the liver. Ann. Intern. Med., 24, 643

    PubMed  CAS  Google Scholar 

  112. Hiller, G. I., Huffman, E. R. and Levey, S. (1949). Studies in cirrhosis of the liver. I. Relationship between plasma volume, plasma protein concentrations and total circulating proteins. J. Clin. Invest., 23, 322

    Google Scholar 

  113. Bateman, J. C., Shorr, H. M. and Elgvin, T. (1949). Hypervolemic anemia in cirrhosis. J. Clin. Invest., 28, 539

    Google Scholar 

  114. Hyde, G. M., Berlin, N. I., Parsons, R. J., Lawrence, J. H. and Port, S. (1952). The blood volume in portal cirrhosis as determined by P32 labeled red blood cells. J. Lab. Clin. Med., 39, 347

    PubMed  CAS  Google Scholar 

  115. Eisenberg, S. (1956). Blood volume in patients with Laennec’s cirrhosis of the liver as determined by radioactive chromium-tagged red cells. Am. J. Med., 20, 189

    PubMed  CAS  Google Scholar 

  116. Adams, E. B. (1970). Anemia associated with protein deficiency. Semin. Hematol., 7, 55

    PubMed  CAS  Google Scholar 

  117. Alfrey, C. P. and Lane, M. (1970). The effect of riboflavin deficiency on erythropoiesis. Semin. Hematol., 7, 49

    PubMed  CAS  Google Scholar 

  118. Post, R. M. and Desforges, J. F. (1968). Thrombocytopenia and alcoholism. Ann. Intern. Med., 68, 1230

    PubMed  CAS  Google Scholar 

  119. Heck, J. and Gehrmann, G. (1972). Alkoholische thrombozytendepression. Deutsch Med. Wochenschr., 97, 1088

    CAS  Google Scholar 

  120. MacLeod, E. C. and Michaels, L. (1969). Alcohol and the blood. Lancet, ii, 1198

    Google Scholar 

  121. Liu, Y. K. (1973). Leukopenia in alcoholics. Am. J. Med., 54, 605

    PubMed  CAS  Google Scholar 

  122. Cowan, D. H. and Hines, J. D. (1974). Alcohol, vitamins and platelets. In N. V. Dimitrov and J. H. Nodine, eds. Drugs and Hematologic Reactions, p. 283. New York: Grune and Stratton

    Google Scholar 

  123. Sullivan, L. W. (1971). Effect of alcohol on platelet production. In J. M. Paulus, ed. Platelet Kinetics, Radioisotopic, Cytological, Mathematical and Clinical Aspects, p. 247. Amsterdam: North-Holland Publishing Co.

    Google Scholar 

  124. Ryback, R. and Desforges, J. (1970). Alcoholic thrombocytopenia in three inpatient drinking alcoholics. Arch. Intern. Med., 125, 475

    PubMed  CAS  Google Scholar 

  125. Haut, M. J. and Cowan, D. H. (1974). The effect of ethanol on hemostatic properties of human blood platelets. Am. J. Med., 56, 22

    PubMed  CAS  Google Scholar 

  126. Sahud, M. A. (1972). Platelet size and number in alcoholic thrombocytopenia. N. Engl. J. Med., 286, 355

    PubMed  CAS  Google Scholar 

  127. Post, R. M. and Desforges, J. F. (1968). Thrombocytopenic effect of ethanol infusion. Blood, 31, 344

    PubMed  CAS  Google Scholar 

  128. Cowan, D. H., Shook, P. J. and Graham, R. C., Jr. (1974). Hypersomolality, effect on platelet function and ultrastructure. Clin. Res., 22, 386A

    Google Scholar 

  129. Cowan, D. H. (1974). Platelet metabolism in alcohol-related thrombocytopenia. Thrombos. Diathes. Haemorrh., 31, 149

    CAS  Google Scholar 

  130. Aster, R. H. (1966). Pooling of platelets in the spleen: role in the pathogenesis of ‘hypersplenic thrombocytopenia’. J. Clin. Invest., 45, 645

    PubMed  CAS  Google Scholar 

  131. Riedler, G. F., Straub, P. W. and Frick, P. G. (1971). Thrombocytopenia in septicemia. Helv. Med. Acta, 36, 23

    PubMed  CAS  Google Scholar 

  132. Verstraete, M., Vermylen, J. and Collen, D. (1974). Intravascular coagulation in liver disease. Ann. Rev. Med., 25, 447

    PubMed  CAS  Google Scholar 

  133. Chanarin, I. (1969). The Megaloblastic Anemias, p. 344. Philadelphia: Blackwell

    Google Scholar 

  134. Welch, W. H. (1903). The pathological effects of alcohol. In J. S. Billings, ed. Physiological Aspects of the Liquor Problem, Vol. 2, p. 351. Boston and New York: Houghton Mifflin

    Google Scholar 

  135. Osler, W. (1927). Modern Medicine. Philadelphia: Lea and Febiger

    Google Scholar 

  136. Lyons, H. A. and Saltzman, A. (1974). Diseases of the respiratory tract in alcoholics. In B. Kissin and H. Begleiter, eds. The Biology of Alcoholism, Volume 3, Clinical Pathology, p. 403. New York: Plenum Press

    Google Scholar 

  137. Chromet, B. and Gach, B. M. (1967). Lobar pneumonia and alcoholism: an analysis of thirty-seven cases. Am. J. Med. Sci., 253, 300

    Google Scholar 

  138. McFarland, E. and Libre, E. P. (1963). Abnormal leucocyte response in alcoholism. Ann. Intern. Med., 59, 865

    PubMed  CAS  Google Scholar 

  139. Craddock, C. G., Jr., Frei, E., Landy, M. and Smith, W. W. (1960). Quantitative studies of human leukocytes and febrile response to single and repeated doses of purified endotoxin. Blood, 15, 840

    PubMed  Google Scholar 

  140. Dunlap, W. M., James, G. W. and Hume, D. M. (1974). Anemia and neutropenia caused by copper deficiency. Ann. Intern. Med., 80, 470

    PubMed  CAS  Google Scholar 

  141. Tisman, G. and Herbert, V. (1973). In vitro myelosuppression and immunosuppression by ethanol. J. Clin. Invest., 52, 1410

    PubMed  CAS  Google Scholar 

  142. Beard, J. D. and Knott, D. H. (1966). Hematopoietic response to experimental chronic alcoholism. Am. J. Med. Sci., 252, 518

    PubMed  CAS  Google Scholar 

  143. Pickrell, K. L. (1938). The effect of alcoholic intoxication and ether anesthesia on resistance to pneumococcal infection. Bull. Johns Hopkins Hosp., 63, 238

    CAS  Google Scholar 

  144. Brayton, R. G., Stokes, P. E., Schwartz, M. S. and Louria, D. B. (1970). Effect of alcohol and various diseases on leukocyte mobilization, phagocytosis, and intracellular bacterial killing. N. Engl. J. Med., 282, 123

    PubMed  CAS  Google Scholar 

  145. Phelps, P. and Stanislau, D. (1969). Polymorphonuclear leukocyte motility in vitro. I. Effect of pH, temperature, ethyl alcohol, and caffeine, using a modified Boyden chamber technique. Arthrit. Rheumatol., 12, 181

    CAS  Google Scholar 

  146. DeMeo, A. N. and Anderson, B. R. (1972). Defective Chemotaxis associated with a serum inhibitor in cirrhotic patients. N. Engl. J. Med., 286, 735

    PubMed  CAS  Google Scholar 

  147. Crowley, J. P. and Abramson, N. (1971). Effect of ethanol on complement-mediated chemotaxis. Clin. Res., 19, 415

    Google Scholar 

  148. Craddock, P. R., Yawata, Y., Van Senten, L., Gilberstadt, S., Silvis, S. and Jacob, H. S. (1974). Acquired phagocyte dysfunction. A complication of the hypophosphatemia of parenteral hyperalimentation. N. Engl. J. Med., 290, 1403

    PubMed  CAS  Google Scholar 

  149. Green, G. M. and Kass, E. H. (1964). Factors influencing the clearance of bacteria by the lung. J. Clin. Invest., 43, 769

    PubMed  CAS  Google Scholar 

  150. Louria, D. B. (1963). Susceptibility to infection during experimental alcohol intoxication. Trans. Ass. Am. Phys., 76, 102

    Google Scholar 

  151. Guarneri, J. J. and Luarenzi, G. A. (1968). Effect of alcohol on the mobilization of alveolar macrophages. J. Lab. Clin. Med., 72, 40

    PubMed  CAS  Google Scholar 

  152. Ali, M. V. and Nolan, J. P. (1967). Alcohol-induced depression of reticuloendothelial function in the rat. J. Lab. Clin. Med., 70, 295

    PubMed  CAS  Google Scholar 

  153. Triger, D. R., Alp, M. H. and Wright, R. (1972). Bacterial and dietary antibodies in liver disease. Lancet, i, 60

    Google Scholar 

  154. Bjorneboe, M., Prytz, H. and Orskov, F. (1972). Antibodies to intestinal microbes in serum of patients with cirrhosis of the liver. Lancet, i, 58

    Google Scholar 

  155. Berenyi, M. R., Straus, B. and Cruz, D. (1974). In vitro and in vivo studies of cellular immunity in alcoholic cirrhosis. Am. J. Dig. Dis., 19, 199

    PubMed  CAS  Google Scholar 

  156. Hsu, C. C. S. and Leevy, C. M. (1971). Inhibition of PHA-stimulated lymphocyte transformation by plasma from patients with advanced alcoholic cirrhosis. Clin. Exp. Immunol., 8, 749

    PubMed  CAS  Google Scholar 

  157. Berkowitz, H., Reichel, J. and Shim, C. (1973). The effect of ethanol on the cough reflex. Clin. Sci. Molec. Med., 45, 527

    CAS  Google Scholar 

  158. Haltalin, K. C., Nelson, J. D., Woodman, E. B. and Allen, A. A. (1970). Fatal Shigella infection induced by folic acid deficiency in young guinea pigs. J. Infect. Dis., 121, 275

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1977 MTP Press Limited

About this chapter

Cite this chapter

Lindenbaum, J. (1977). Metabolic Effects of Alcohol on the Blood and Bone Marrow. In: Lieber, C.S. (eds) Metabolic Aspects of Alcoholism. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-6153-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-6153-4_8

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-011-6155-8

  • Online ISBN: 978-94-011-6153-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics