This paper is only available as a PDF. To read, Please Download here.
Abstract
Thrombokinetic studies were done in 5 folate-deficient and 3 folate-replete alcoholic
subjects to evaluate the mechanism of alcohol-related thrombocytopenia. Measurements
were done during abstinence and during a period of supervised alcohol ingestion on
a metabolic ward. Thrombocytopenia developed during alcohol ingestion in 3 of the
5 folate-deficient and 2 of the 3 folate-replete subjects. Total thrombopoiesis, determined
from the total mass of megakaryocytes, increased 1.5 to 3.0-fold in the folate-deficient
thrombocytopenic patients with alcohol ingestion. No change and a 1.6-fold increase
in total thrombopoiesis were observed in the 2 folate-replete thrombocytopenic patients.
Platelet life-span during alcohol-related thrombocytopenia was 2.2 to 3.8 days as
compared to 8.0 to 9.0 days during abstinence; effective thrombopoiesis, determined
from the platelet turnover, decreased 30 to 50 per cent. During ingestion, total thrombopoiesis
in the folate-deficient and folate-replete thrombocytopenic patients was, respectively,
4.7 and 2.7 times greater than effective thrombopoiesis. With alcohol ingestion unaccompanied
by thrombocytopenia (3 patients), changes in megakaryocytes were variable, platelet
life-span was 50, 75, and 100 per cent of control, effective thrombopoiesis was increased
1.1 to 1.5-fold, and the ratio of total to effective thrombopoiesis was unchanged
or decreased. Survival of normal homologous platelets in a thrombocytopenic alcoholic
recipient was 25 per cent below normal. Platelet counts during intravenous ethanol
administration varied from 82 to 109 per cent of pre-infusion values. The results
indicate that alcohol-related thrombocytopenia is characterized by a reduced platelet
life-span and an inability of the marrow to compensate appropriately for the premature
removal of the platelets from the bloodstream.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Translational ResearchAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Suppression of hematopoiesis by ethanol.J Clin Invest. 1964; 43: 2048-2062
- Thrombocytopenia in alcoholics.Ann Intern Med. 1968; 68: 526-532
- Thrombocytopenia and alcoholism.Ann Intern Med. 1968; 68: 1230-1236
- Hematologic effects of alcohol in man in the absence of nutritional deficiency.N Engl J Med. 1969; 281: 333-338
- Alcoholic thrombocytopenia in three inpatient drinking alcoholics.Arch Intern Med. 1970; 125: 475-477
- Thrombocytopenia of severe alcoholism.Ann Intern Med. 1971; 74: 37-43
- Alcohol-induced thrombocytopenia in man.J Clin Invest. 1968; 47 (Abst.): 95a
- Pathogenesis of alcohol-induced sideroblastic bone marrow abnormalities.N Engl J Med. 1970; 283: 441-446
- A syllabus of laboratory examinations in clinical diagnosis.Harvard University Press, Cambridge1961
- The reproducibility and constancy of the platelet count.Am J Clin Pathol. 1953; 23: 15-26
- Aseptic addition method for Lactobacillus casei assay of folate activity in human serum.J Clin Pathol. 1966; 19: 12-16
- Method of assay of red cell folate activity and the value of the assay as a test for folate deficiency.J Clin Pathol. 1966; 19: 17-28
- A sugar-containing basal medium for vitamin B12 assay with Euglena; application to body fluids.J Protozool. 1956; 3: 101-112
- Investigations into the Euglena method for the assay of the vitamin B12 in serum.J Clin Pathol. 1964; 17: 14-26
- Determination of serum and blood pyridoxal phosphate concentrations with purified rabbit skeletal muscle phosphorylase b.J Lab Clin Med. 1969; 73: 343-349
- Bound iron and unsaturated iron-binding capacity; rapid and reliable quantitative determination.in: Ed. 4. Proc Soc Exp Biol Med. 87. 1954: 443-448
- Megakaryocyte quantitation.J Clin Invest. 1968; 47: 452-457
- Thrombokinetics in man.J Clin Invest. 1969; 48: 963-974
- Ferrokinetics: A biologic model for plasma iron exchange in man.J Clin Invest. 1970; 49: 197-205
- Platelet sequestration in man. I. Methods.J Clin Invest. 1964; 43: 843-855
- Pooling of platelets in the spleen; role in the pathogenesis of “hypersplenic” thrombocytopenia.J Clin Invest. 1966; 45: 645-657
- Protein measurement with the Folin phenol reagent.J Biol Chem. 1951; 193: 265-275
- Platelet size and number in alcoholic thrombocytopenia.N Engl J Med. 1972; 286: 355-356
- Heterogeneity of human platelets. I. Metabolic and kinetic evidence suggestive of young and old platelets.J Clin Invest. 1969; 48: 1073-1082
- Platelet size in relation to platelet age.in: Ed. 4. Proc Soc Exp Biol Med. 115. 1964: 684-689
Haut MJ and Cowan DH: The effect of ethanol on hemostatic properties of human blood platelets. Submitted for publication.
Article info
Publication history
Accepted:
September 29,
1972
Received:
June 19,
1972
Footnotes
☆Supported by Hematology Training Grant No. AM05420-05 from the United States Public Health Service, General Research Support Grant No. RR-05410 from the National Institutes of Health, and Grant No. MH-19558 from the National Institutes of Mental Health.
☆☆A portion of this paper was presented at the Forty-second Annual Meeting of the Central Society for Clinical Research, October 31, 1969.
Identification
Copyright
© 1973 Published by Elsevier Inc.
