To the Editor.
—The Photo/Essay "Intravascular Erythrophagocytosis" by Friedman and Dracker1 makes a useful and interesting point. However, one aspect of the report may need clarification.As an in vivo phenomenon, erythrophagocytosis by circulating leukocytes is indeed rare, as evidenced by the authors' list of references to 12 cases in the world literature going back as far as 1910. In vitro erythrophagocytosis is not quite so difficult to come by and can in fact be demonstrated by a careful observer in a high proportion of blood samples from patients with Coombs-positive hemolytic anemias and other states.My basis for making this assertion is an extensive experience with films of preincubated blood acquired over a period of years when I was involved in investigation of the lupus erythematosus cell phenomenon.Blood films described by authors writing before 1970 (10 of the 12 cases quoted) were routinely prepared at the bedside
Lee SL. Intravascular Erythrophagocytosis. JAMA. 1991;266(2):217–218. doi:10.1001/jama.1991.03470020043027
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