Abnormal bone marrow morphology in the premature infant associated with maternal alcohol infusion

Hematological complications of alcoholism

Numerous clinical observations support the notion that ethanol has multiple pathologic effects on hematopoietic tissue. The effects of alcohol on blood are diverse. The long-term ingestion of large quantities of ethanol has been shown to alter a substantial number of physiologic and biochemical variables. Abnormalities involving leukocytes, platelets, and erythrocytes may occur singly or in various combinations. Due to the frequent concomitant presence of alcohol-related hepatic disease, nutritional deficiencies, infection, and other chronic diseases, it is often difficult to distinguish the specific hematologic toxicities of alcohol ingestion from the hematologic toxicities of associated morbid conditions. Depressed hematopoietic cell formation (Table 2), increased destruction, and alterations in morphology and function of hematopoietic cells have been described.

A critical evaluation of the obstetric use of alcohol in preterm labor

The clinical use of alcohol to delay premature labor is critically reviewed. The evidence indicates that this procedure is no more effective in arresting preterm labor than placebo, i.e., bed rest. The rational for the clinical use of alcohol in obstetrics is also questionable. Furthermore, increasing evidence indicates that the blood alcohol levels associated with this method often causes nausea, vomiting, and headaches in mothers and can cause deleterious effects in the fetus, including death.

Cytoplasmic vacuolation of peripheral blood cells in acute alcoholism

Cytoplasmic vacuolation of peripheral blood leucocytes is reported in three patients with acute alcoholism. Apparently this is the first report of vacuolation of peripheral blood leucocytes associated with acute alcoholism. Apart from any direct cytotoxic effect of alcohol the metabolic acidosis and hypoglycaemia associated with acute alcoholic poisoning may be important factors in the pathogenesis of the morphological changes.

A new syndrome of refractory sideroblastic anemia with vacuolization of marrow precursors and exocrine pancreatic dysfunction

In the past decade, we have studied four unrelated children with what we believe is a previously unreported disorder affecting the bone marrow and exocrine pancreas. During infancy these patients had the onset of severe, transfusion-dependent, macrocytic anemia plus a variable degree of neutropenia and thrombocytopenia. Their bone marrows had normal cellularity but were characterized by remarkable vacuolization of erythroid and myeloid precursors, hemosiderosis, and ringed sideroblasts. The vacuoles probably represented manifestations of cellular degeneration and death. In two patients, in vitro bone marrow cultures showed abnormal erythroid and myeloid progenitor cell growth and, in one child, abnormal vacuolated erythroid colonies. Family histories were unrevealing, parents were hematologically normal, and both sexes were involved. There was no evidence of specific nutritional deficiencies or exposure to agents associated with marrow vacuolization. A number of therapeutic interventions produced no effect. One child had clinical malabsorption. This child and one other had extensive pancreatic fibrosis at autopsy. The other two patients had findings indicating exocrine pancreatic dysfunction. Two children had splenic atrophy. This new syndrome, with associated bone marrow and exocrine pancreatic dysfunctions, differs in several respects from the syndrome of pancreatic liposis and neutropenia described by Shwachman et all and Bodian et al, and from other conditions with vacuolization of the marrow or sideroblastosis.