Abstract
Sixty-three patients regularly drinking more than 80 g. ethanol daily were studied. Macrocytosis was present in 89%, generally unassociated with anæmia. Megaloblastic changes were seen in only a third of the marrow samples and the remainder were normoblastic. Serum, red blood-cell, and liver folate levels were reduced in approximately one-third of the patients. Six patients with megaloblastic changes had normal serum, red blood-cell, and liver folate levels. Macrocytosis disappeared on alcohol withdrawal alone, but persisted, despite folate supplement, when alcohol intake was not curtailed. Macrocytosis is one of the commonest abnormalities in alcoholics in the U.K., and seems to be due to a direct action of alcohol on the developing erythroblasts. It is not necessarily related to folate deficiency.
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