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Anemia in alcoholics.

D Savage, J Lindenbaum

    Medicine
    |September 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Anemia in alcoholics often has multiple causes, including megaloblastic and sideroblastic changes. Serum ferritin is a reliable indicator of absent iron stores, aiding diagnosis and treatment.

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    Area of Science:

    • Hematology
    • Gastroenterology
    • Internal Medicine

    Background:

    • Anemia is a common complication in chronic alcoholism.
    • Identifying the specific causes of anemia in alcoholics is crucial for effective treatment.

    Purpose of the Study:

    • To develop a diagnostic approach for anemia in chronic alcoholics.
    • To evaluate the contributing factors and diagnostic markers for anemia in this population.

    Main Methods:

    • Evaluation of 121 chronic alcoholics with low hematocrit.
    • Assessment of bone marrow morphology, including megaloblastic and sideroblastic changes.
    • Analysis of red blood cell indices (MCV), neutrophil hypersegmentation, macroovalocytosis, and serum markers (folate, iron, ferritin).

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    Main Results:

    • Multiple causes of anemia were frequent, including megaloblastic (33.9%) and sideroblastic (23.1%) changes.
    • Mean Corpuscular Volume (MCV) had limited value in predicting megaloblastic change.
    • Neutrophil hypersegmentation and macroovalocytosis showed varying sensitivity and specificity.
    • Serum ferritin levels < 100 ng/ml demonstrated high sensitivity (100%) and specificity (95%) for absent marrow iron stores.
    • Alcohol's direct toxic effect on erythroid precursors, independent of folate deficiency, is a potential mechanism for megaloblastic hematopoiesis.

    Conclusions:

    • Anemia in alcoholics is multifactorial, requiring a comprehensive diagnostic approach.
    • Serum ferritin is a valuable tool for assessing iron deficiency in this population.
    • Guidelines for the evaluation and therapy of anemia in alcoholics have been formulated based on these findings.