Bone Marrow-Erythroid Morphology in Alcoholic Patients

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Abstract
Bone marrow-erythroid morphology in 26 male alcoholic patients was normoblastic, megaloblastic, or megaloblastoid. Abnormal vacuoles were present in the erythroid precursors in each type of erythroid morphology and occurred in 54% of patients. Similar vacuoles were present to a lesser extent in the marrow granulocytic cells. The occurrence of vacuoles did not correlate with diet, serum-folate levels, type of alcoholic beverage, liver histopathology, or with the type or degree of anemia. The vacuolization appeared to result from a direct effect of ethyl alcohol and disappeared rapidly with alcoholic abstinence. The bone marrow-erythroid morphology correlated well with dietary folate, serum-folate levels, and with the type of alcoholic beverage consumed. Individuals with normoblastic morphology were primarily beer drinkers and those with megaloblastic or megaloblastoid morphology were essentially wine and whiskey imbibers. Fatty liver, a prominent feature in the liver biopsies, was present in patients with each type of marrow-erythroid morphology. Fatty liver did not correlate with marrow vacuolization, serum-folate levels, or with the type of alcoholic beverage consumed.

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