Many years ago Weil1 suggested a role of tissue lysins in the physiologic breakdown of red blood cells and in the pathogenesis of some cases of idiopathic, hemolytic anemia and of anemia in patients with cancer. More recently, the role of lipids in the pathogenesis of red blood cell destruction in patients with chronic hemolytic anemia has been emphasized by Johnson and co-workers2 and by Evans.3 These observations, although reviewed by Ponder4 in masterly fashion, have not received due emphasis. While there has been ample confirmation that tissue lipids have strong hemolytic activity in vitro, few attempts have been made to correlate these biochemical findings with the pathogenesis of the hemolytic anemias.
A recent paper5 reemphasizes the role of tissue systems in the pathogenesis of hemolytic anemia where no "immune" mechanisms may be demonstrated. The study consisted of the analysis of the hemolytic and antihemolytic constituents
TISSUE ABNORMALITIES IN HEMOLYTIC ANEMIAS. JAMA. 1962;179(9):721. doi:10.1001/jama.1962.03050090049011
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