MACROCYTIC been repeatedly observed in Western countries. Assuming that the function of the liver plays a part in normal erythropoiesis, Van Duyn1b stated the belief that the pathologic changes in that organ might be held indirectly responsible for the development of the macrocytic blood picture. Davidson and Fullerton2 suggested that the macrocytic anemias of hepatic disease are caused by failure of the final stages of synthesis of the hemopoietic principle rather than by failure to store the substance.
Goldhamer and his associates3 observed that an extract prepared post mortem from the liver of a patient with cirrhosis and macrocytic anemia was ineffective in eliciting a hemopoietic response when administered parenterally to a patient with pernicious anemia in relapse. This observation with other experimental data led them to conclude that the specific hemopoietic substance might not be stored by a severely damaged liver or, even though stored, might
HUANG DK, WANG DH. ANEMIA ASSOCIATED WITH CIRRHOSIS OF THE LIVER: Study of Thirty-Two Cases. Arch Intern Med (Chic). 1949;84(6):958–964. doi:10.1001/archinte.1949.00230060115008
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