Studies on the Pathogenesis of Alcohol-Induced Sideroblastic Bone-Marrow Abnormalities

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Abstract
Excessive amounts of alcohol were administered to three alcoholic volunteer subjects while all were on a nutritionally adequate diet except for folate content. In all three subjects folate deficiency, hypomagnesemia, hypokalemia and biochemical evidence of altered liver function developed. In vivo conversion of exogenously administered pyridoxine to pyridoxal phosphate was affected in all three. Hyperferremia, increased plasma radio-iron turnover with decreased erythrocyte iron utilization, dimorphic anemia associated with bone-marrow sideroblastic alterations and thrombocytopenia developed in two of the three subjects. Following treatment with parenteral pyridoxal phosphate the marrow sideroblastic abnormalities reverted to normal, and serum iron levels decreased markedly. Treatment with pharmacologic amounts of folic acid and pyridoxine had no such effect. In some alcoholic patients administration of alcohol seems to produce bone-marrow sideroblastic changes secondary to its effect on vitamin B6 metabolism.