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DECREASED RED CELL SURVIVAL ASSOCIATED WITH LIVER DISEASE: Use of Radioactive Sodium Chromate in Measurement of Red Cell Survival

DECREASED RED CELL SURVIVAL ASSOCIATED WITH LIVER DISEASE: Use of Radioactive Sodium Chromate in... Abstract IT HAS been known for many years that anemia is frequently present in chronic liver disease, especially in cirrhosis of the liver. The etiology, however, has been obscure and has been the subject of considerable discussion. Since the anemia is often macrocytic in type, as first noted by Gram, in 1883,1 and subsequently confirmed by others,* it was only natural that a deficiency in the anti-pernicious-anemia factor be suspected. This explanation, however, has been largely discredited because of the lack of response to liver extract † and because the bone marrow is rarely megaloblastic in character.‡ In addition, it has been shown by Schiff and coworkers 15 that extracts made from cirrhotic livers are able to produce a hematological remission in patients with pernicious anemia. In 1904 Bleichroeder first described the occurrence of red bone marrow in the femur of patients with cirrhosis and made the statement that "in References 1. References 2-10. 2. References 4, 5, 11, and 12. 3. References 10-14. 4. References 19-22. 5. References 10-14. 6. References 10, 14, and 24-26. 7. References 29 and 30. 8. References 31 and 32. 9. The radioactive sodium chromate used in these studies was obtained from the Abbott Laboratories on allocation from the Isotopes Division, United States Atomic Energy Commission, Oak Ridge, Tenn. 10. Gram, H. C. J.: Undersøgelser over de røde Blodlegemers Størrelse hos Mennesket , Kjøbenhavn, V. Thaning & Appel, 1883. 11. Capps, J. A.: A Study of Volume Index: Observations upon the Volume of Erythrocytes in Various Disease Conditions , J. M. Res. 10:367, 1903. 12. Talley, J. E.: The Anemia of Hepatic Cirrhosis Simulating the Pernicious Type , J. A. M. A. 51:1143, 1908.Crossref 13. Wintrobe, M. M., and Shumacker, H. S., Jr.: The Occurrence of Macrocytic Anemia in Association with Disorder of the Liver , Bull. Johns Hopkins Hosp. 52:387, 1933. 14. Rosenberg, D. H., and Walters, A.: Macrocytic Anemia in Liver Disease, Particularly Cirrhosis: Observations on the Incidence, Course, and Reticulocytosis, with a Correlated Study of the Gastric Acidity , Am. J. M. Sc. 192:86, 1936.Crossref 15. Gottardo, P., and Winters, W. L.: Portal Cirrhosis: A Correlation of Clinical, Laboratory, Peritonioscopic and Autopsy Findings , Am. J. M. Sc. 204:205, 1942.Crossref 16. Wintrobe, M. M.: Relation of Disease of the Liver to Anemia: Type of Anemia, Response to Treatment, and Relation of Type of Anemia to Histopathologic Changes in Liver, Spleen and Bone Marrow , Arch. Int. Med. 57:289, 1936.Crossref 17. Wright, D. O.: Macrocytic Anemia and Hepatic Cirrhosis , Am. J. M. Sc. 189:115, 1935.Crossref 18. Davidson, L. S. P., and Fullerton, H. W.: Some Rare Types of Macrocytic Anemia , Quart. J. Med. 7:43, 1938. 19. Meulengracht, E., and Gormsen, H.: Blood and Bone Marrow in Infective Subacute and Chronic Atrophy of the Liver , Blood 3:1416, 1948. 20. Limarzi, L. R.; Jones, R. M.; Paul, J. T., and Poncher, H. G.: Sternal Marrow in Banti's Syndrome and Other Splenomegalic States: The Effect of Splenectomy , Am. J. Clin. Path. 13:231, 1943. 21. Jarrold, T., and Vilter, R. W.: Hematologic Observations in Patients with Chronic Hepatic Insufficiency: Sternal Bone Marrow, Morphology and Bone Marrow Plasmacytosis , J. Clin. Invest. 28:286, 1949.Crossref 22. Huang, K., and Wang, H.: Anemia Associated with Cirrhosis of the Liver: Study of 32 Cases , Arch. Int. Med. 84:958, 1949.Crossref 23. Berman, L.; Axelrod, A. R.; Horan, T. N.; Jacobson, S. D.; Sharp, E. A., and von der Heide, E. C.: The Blood and Bone Marrow in Patients with Cirrhosis of the Liver , Blood 4:511, 1949. 24. Schiff, L.; Rich, M. L., and Simon, S. D.: The "Hematopoietic Principle" in the Diseased Human Liver , Am. J. M. Sc. 196:313, 1938.Crossref 25. Bleichroeder, F.: Über Lebercirrhose und Blutkrankheiten , Arch. path. Anat. 177:435, 1904.Crossref 26. Eppinger, H.: Die hepato-lienalen Erkrankungen , Berlin, Springer-Verlag, 1920. 27. Watson, C. J.: Studies of Urobilinogen; III. The per Diem Excretion of Urobilinogen in the Common Forms of Janudice and Diseases of the Liver , Arch. Int. Med. 59:206, 1937.Crossref 28. Watson, C. J.: Hemolytic Jaundice and Macrocytic Hemolytic Anemia: Certain Observations in a Series of 35 Cases , Ann. Int. Med. 12:1782, 1939.Crossref 29. Farrar, G. E., Jr.; Burnett, W. E., and Steigman, A. J.: Hemolysinic Anemia and Hepatic Degeneration Cured by Splenectomy , Am. J. M. Sc. 200:164, 1940.Crossref 30. Stacey, R. S.: Recurrent Fatal Hemolytic Anemia Associated with Gross Liver Damage and Splenomegaly , Am. J. M. Sc. 212:586, 1946.Crossref 31. Hyman, G. A., and Southworth, H.: Hemolytic Anemia Associated with Liver Disease , Am. J. M. Sc. 221:448, 1951.Crossref 32. Chaplin, H., Jr., and Mollison, P. L.: Red Cell Life-Span in Nephritis and in Hepatic Cirrhosis , Clin. Sc. 12:351, 1953. 33. King, R. B.: The Blood Picture in Portal Cirrhosis of the Liver: A Report Based on 100 Cases , New England J. Med. 200:482, 1929.Crossref 34. Ratnoff, O. D., and Patek, A. J.: The Natural History of Laennec's Cirrhosis of the Liver , Medicine 21:207, 1942. 35. Morlock, C. G., and Hall, B. E.: Association of Cirrhosis, Thrombopenia and Hemorrhagic Tendency , Arch. Int. Med. 72:69, 1943.Crossref 36. Ashby, W. J.: Span of Life of the Red Blood Cell: A Resumé , Blood 3:486, 1948. 37. Eadie, G. S., and Brown, I. W., Jr.: Analytical Review: Red Blood Cell Survival Studies , Blood 8:1110, 1953. 38. Necheles, T. F.; Weinstein, I. M., and LeRoy, G. V.: Radioactive Sodium Chromate for the Study of Survival of Red Blood Cells: I. The Effect of Radioactive Sodium Chromate on Red Cells , J. Lab. & Clin. Med. 42:358, 1953. 39. Weinstein, I. M., and LeRoy, G. V.: Radioactive Sodium Chromate for the Study of Survival of Red Blood Cells: II. The Rate of Hemolysis in Certain Hematologic Disorders , J. Lab. & Clin. Med. 42:368, 1953. 40. Ebaugh, F. G., Jr.; Emerson, C. P., and Ross, J. F.: The Use of Radioactive Chromium51 as an Erythrocyte Tagging Agent for the Determination of Red Cell Survival in Vivo , J. Clin. Invest. 32:1260, 1953. 41. Read, R. C.; Wilson, G. W., and Gardner, F. H.: The Use of Radioactive Sodium Chromate to Evaluate the Life Span of the Red Blood Cells in Health and Certain Hematologic Disorders , Am. J. M. Sc. 228:40, 1954. 42. Capps, R. B.; Weinstein, I. M.; Ettinger, R. H., and Jones, P. N.: Red Cell Survival Studies in Liver Disease , Tr. A. Am. Physicians 67:133, 1954. 43. Wintrobe, M. M.: Clinical Hematology , Ed. 3, Philadelphia, Lea & Febiger, 1951. 44. Dameshek, W.: A Method for the Simultaneous Enumeration of Blood Platelets and Reticulocytes , Arch. Int. Med. 50:579, 1932. 45. Schwartz, S.; Sborov, V., and Watson, C. J.: Studies of Urobilinogen: IV. The Quantitative Determination of Urobilinogen by Means of the Evelyn Photoelectric Colorimeter , Am. J. Clin. Path. 14:598, 1944. 46. Capps, R. B., and Norcross, P.: Hepatic Insufficiency , M. Clin. North America 33:447, 1949. 47. Readinger, H. M.; Swift, W. E., Jr.; Gardner, H. T., and Sheedy, J. A.: Oral Cholecystography in Patients with Viral Hepatitis , Am. J. Med. 8:611, 1950. 48. Crosby, W. H., and Akeroyd, J. H.: The Limit of Hemoglobin Synthesis in Hereditary Hemolytic Anemia , Am. J. Med. 13:273, 1952. 49. Brown, G. M.: The Pathogenesis of Secondary Anaemias , Canad. M. A. J. 62:472, 1950. 50. Sborov, V. M.; Giges, B.; Plough, I. C., and Mandel, W.: ACTH Therapy in Acute Viral Hepatitis , J. Lab. & Clin. Med. 43:48, 1954. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

DECREASED RED CELL SURVIVAL ASSOCIATED WITH LIVER DISEASE: Use of Radioactive Sodium Chromate in Measurement of Red Cell Survival

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American Medical Association
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Copyright © 1955 American Medical Association. All Rights Reserved.
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0888-2479
DOI
10.1001/archinte.1955.00250070109013
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Abstract

Abstract IT HAS been known for many years that anemia is frequently present in chronic liver disease, especially in cirrhosis of the liver. The etiology, however, has been obscure and has been the subject of considerable discussion. Since the anemia is often macrocytic in type, as first noted by Gram, in 1883,1 and subsequently confirmed by others,* it was only natural that a deficiency in the anti-pernicious-anemia factor be suspected. This explanation, however, has been largely discredited because of the lack of response to liver extract † and because the bone marrow is rarely megaloblastic in character.‡ In addition, it has been shown by Schiff and coworkers 15 that extracts made from cirrhotic livers are able to produce a hematological remission in patients with pernicious anemia. In 1904 Bleichroeder first described the occurrence of red bone marrow in the femur of patients with cirrhosis and made the statement that "in References 1. References 2-10. 2. References 4, 5, 11, and 12. 3. References 10-14. 4. References 19-22. 5. References 10-14. 6. References 10, 14, and 24-26. 7. References 29 and 30. 8. References 31 and 32. 9. The radioactive sodium chromate used in these studies was obtained from the Abbott Laboratories on allocation from the Isotopes Division, United States Atomic Energy Commission, Oak Ridge, Tenn. 10. Gram, H. C. J.: Undersøgelser over de røde Blodlegemers Størrelse hos Mennesket , Kjøbenhavn, V. Thaning & Appel, 1883. 11. Capps, J. A.: A Study of Volume Index: Observations upon the Volume of Erythrocytes in Various Disease Conditions , J. M. Res. 10:367, 1903. 12. Talley, J. E.: The Anemia of Hepatic Cirrhosis Simulating the Pernicious Type , J. A. M. A. 51:1143, 1908.Crossref 13. Wintrobe, M. M., and Shumacker, H. S., Jr.: The Occurrence of Macrocytic Anemia in Association with Disorder of the Liver , Bull. Johns Hopkins Hosp. 52:387, 1933. 14. Rosenberg, D. H., and Walters, A.: Macrocytic Anemia in Liver Disease, Particularly Cirrhosis: Observations on the Incidence, Course, and Reticulocytosis, with a Correlated Study of the Gastric Acidity , Am. J. M. Sc. 192:86, 1936.Crossref 15. Gottardo, P., and Winters, W. L.: Portal Cirrhosis: A Correlation of Clinical, Laboratory, Peritonioscopic and Autopsy Findings , Am. J. M. Sc. 204:205, 1942.Crossref 16. Wintrobe, M. M.: Relation of Disease of the Liver to Anemia: Type of Anemia, Response to Treatment, and Relation of Type of Anemia to Histopathologic Changes in Liver, Spleen and Bone Marrow , Arch. Int. Med. 57:289, 1936.Crossref 17. Wright, D. O.: Macrocytic Anemia and Hepatic Cirrhosis , Am. J. M. Sc. 189:115, 1935.Crossref 18. Davidson, L. S. P., and Fullerton, H. W.: Some Rare Types of Macrocytic Anemia , Quart. J. Med. 7:43, 1938. 19. Meulengracht, E., and Gormsen, H.: Blood and Bone Marrow in Infective Subacute and Chronic Atrophy of the Liver , Blood 3:1416, 1948. 20. Limarzi, L. R.; Jones, R. M.; Paul, J. T., and Poncher, H. G.: Sternal Marrow in Banti's Syndrome and Other Splenomegalic States: The Effect of Splenectomy , Am. J. Clin. Path. 13:231, 1943. 21. Jarrold, T., and Vilter, R. W.: Hematologic Observations in Patients with Chronic Hepatic Insufficiency: Sternal Bone Marrow, Morphology and Bone Marrow Plasmacytosis , J. Clin. Invest. 28:286, 1949.Crossref 22. Huang, K., and Wang, H.: Anemia Associated with Cirrhosis of the Liver: Study of 32 Cases , Arch. Int. Med. 84:958, 1949.Crossref 23. Berman, L.; Axelrod, A. R.; Horan, T. N.; Jacobson, S. D.; Sharp, E. A., and von der Heide, E. C.: The Blood and Bone Marrow in Patients with Cirrhosis of the Liver , Blood 4:511, 1949. 24. Schiff, L.; Rich, M. L., and Simon, S. D.: The "Hematopoietic Principle" in the Diseased Human Liver , Am. J. M. Sc. 196:313, 1938.Crossref 25. Bleichroeder, F.: Über Lebercirrhose und Blutkrankheiten , Arch. path. Anat. 177:435, 1904.Crossref 26. Eppinger, H.: Die hepato-lienalen Erkrankungen , Berlin, Springer-Verlag, 1920. 27. Watson, C. J.: Studies of Urobilinogen; III. The per Diem Excretion of Urobilinogen in the Common Forms of Janudice and Diseases of the Liver , Arch. Int. Med. 59:206, 1937.Crossref 28. Watson, C. J.: Hemolytic Jaundice and Macrocytic Hemolytic Anemia: Certain Observations in a Series of 35 Cases , Ann. Int. Med. 12:1782, 1939.Crossref 29. Farrar, G. E., Jr.; Burnett, W. E., and Steigman, A. J.: Hemolysinic Anemia and Hepatic Degeneration Cured by Splenectomy , Am. J. M. Sc. 200:164, 1940.Crossref 30. Stacey, R. S.: Recurrent Fatal Hemolytic Anemia Associated with Gross Liver Damage and Splenomegaly , Am. J. M. Sc. 212:586, 1946.Crossref 31. Hyman, G. A., and Southworth, H.: Hemolytic Anemia Associated with Liver Disease , Am. J. M. Sc. 221:448, 1951.Crossref 32. Chaplin, H., Jr., and Mollison, P. L.: Red Cell Life-Span in Nephritis and in Hepatic Cirrhosis , Clin. Sc. 12:351, 1953. 33. King, R. B.: The Blood Picture in Portal Cirrhosis of the Liver: A Report Based on 100 Cases , New England J. Med. 200:482, 1929.Crossref 34. Ratnoff, O. D., and Patek, A. J.: The Natural History of Laennec's Cirrhosis of the Liver , Medicine 21:207, 1942. 35. Morlock, C. G., and Hall, B. E.: Association of Cirrhosis, Thrombopenia and Hemorrhagic Tendency , Arch. Int. Med. 72:69, 1943.Crossref 36. Ashby, W. J.: Span of Life of the Red Blood Cell: A Resumé , Blood 3:486, 1948. 37. Eadie, G. S., and Brown, I. W., Jr.: Analytical Review: Red Blood Cell Survival Studies , Blood 8:1110, 1953. 38. Necheles, T. F.; Weinstein, I. M., and LeRoy, G. V.: Radioactive Sodium Chromate for the Study of Survival of Red Blood Cells: I. The Effect of Radioactive Sodium Chromate on Red Cells , J. Lab. & Clin. Med. 42:358, 1953. 39. Weinstein, I. M., and LeRoy, G. V.: Radioactive Sodium Chromate for the Study of Survival of Red Blood Cells: II. The Rate of Hemolysis in Certain Hematologic Disorders , J. Lab. & Clin. Med. 42:368, 1953. 40. Ebaugh, F. G., Jr.; Emerson, C. P., and Ross, J. F.: The Use of Radioactive Chromium51 as an Erythrocyte Tagging Agent for the Determination of Red Cell Survival in Vivo , J. Clin. Invest. 32:1260, 1953. 41. Read, R. C.; Wilson, G. W., and Gardner, F. H.: The Use of Radioactive Sodium Chromate to Evaluate the Life Span of the Red Blood Cells in Health and Certain Hematologic Disorders , Am. J. M. Sc. 228:40, 1954. 42. Capps, R. B.; Weinstein, I. M.; Ettinger, R. H., and Jones, P. N.: Red Cell Survival Studies in Liver Disease , Tr. A. Am. Physicians 67:133, 1954. 43. Wintrobe, M. M.: Clinical Hematology , Ed. 3, Philadelphia, Lea & Febiger, 1951. 44. Dameshek, W.: A Method for the Simultaneous Enumeration of Blood Platelets and Reticulocytes , Arch. Int. Med. 50:579, 1932. 45. Schwartz, S.; Sborov, V., and Watson, C. J.: Studies of Urobilinogen: IV. The Quantitative Determination of Urobilinogen by Means of the Evelyn Photoelectric Colorimeter , Am. J. Clin. Path. 14:598, 1944. 46. Capps, R. B., and Norcross, P.: Hepatic Insufficiency , M. Clin. North America 33:447, 1949. 47. Readinger, H. M.; Swift, W. E., Jr.; Gardner, H. T., and Sheedy, J. A.: Oral Cholecystography in Patients with Viral Hepatitis , Am. J. Med. 8:611, 1950. 48. Crosby, W. H., and Akeroyd, J. H.: The Limit of Hemoglobin Synthesis in Hereditary Hemolytic Anemia , Am. J. Med. 13:273, 1952. 49. Brown, G. M.: The Pathogenesis of Secondary Anaemias , Canad. M. A. J. 62:472, 1950. 50. Sborov, V. M.; Giges, B.; Plough, I. C., and Mandel, W.: ACTH Therapy in Acute Viral Hepatitis , J. Lab. & Clin. Med. 43:48, 1954.

Journal

A.M.A. Archives of Internal MedicineAmerican Medical Association

Published: Jan 1, 1955

References