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Nutritional anemia in alcoholism

J Lindenbaum, M J Roman

    The American Journal of Clinical Nutrition
    |December 1, 1980
    PubMed
    Summary

    Folate deficiency causes megaloblastic anemia in alcoholics. Alcoholism also causes macrocytosis and sideroblastic anemia, with specific blood cell changes aiding diagnosis.

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    Area of Science:

    • Hematology
    • Nutritional Science
    • Gastroenterology

    Background:

    • Alcoholism is a common cause of anemia, particularly megaloblastic anemia due to folate deficiency.
    • Alcohol's antifolate action and poor diet contribute to folate depletion in alcoholics.
    • Alcoholism can also cause macrocytosis and sideroblastic anemia, even without significant folate depletion.

    Purpose of the Study:

    • To explore the hematological consequences of alcoholism, focusing on anemia types and diagnostic markers.
    • To differentiate between folate deficiency anemia and other alcohol-related anemias.
    • To investigate the role of folate and other factors in alcohol-induced sideroblastic anemia.

    Main Methods:

    • Review of clinical presentation and laboratory findings in hospitalized alcoholics with anemia.
    • Analysis of peripheral blood smears for neutrophil hypersegmentation and siderocytes.
    • Evaluation of serum folate concentrations and bone marrow morphology during treatment.

    Main Results:

    • Megaloblastic anemia from folate deficiency is common in alcoholics, indicated by neutrophil hypersegmentation.
    • Alcoholism itself can cause macrocytosis and sideroblastic anemia, with siderocytes as a diagnostic clue.
    • Erythrocyte mean corpuscular volume may be normal or elevated despite hypochromic microcytes; vitamin B6 is not clearly implicated.

    Conclusions:

    • Neutrophil hypersegmentation is a reliable indicator of folate depletion in alcoholics.
    • Sideroblastic anemia is a reversible complication of alcoholism, potentially linked to heme synthesis inhibition.
    • Accurate diagnosis of anemia in alcoholics requires considering multiple factors beyond serum folate levels.

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