Effects of Ethanol in Blood Cells and Bone Marrow
Heavy ethanol intake may affect both blood cells and their bone marrow progenitors (Malik and Wickramasinghe 1986, Lindenbaum 1987, Niemela and Parkkila 2004). Elevated MCV (Macrocytosis) is the most typical abnormality occurring as a result of heavy drinking (morgan et al., 1981, Wymer and Becker, 1990).
Macrocytosis in alcohol abusers is usually relatively mild in degree (MCV of 96-100), but other abnormalities in the erythropoietic cell lineage including erythroblast vacuolization in bone marrow, have also been reported (Lindenbaum 1987).
Anemia is common in alcoholics with liver disease, as also are folate deficiency and megaloblastic alterations in bone marrow (Lindenbaum., 1987, Niemela and Parkkila 2004). Ethanol consumption with an inadequate diet has been associated with the appearance of ring sideroblasts in bone marrow, and ethanol has also been reported to inhibit a number of enzymatic steps in heme synthesis (lindenbaum 1987).
There may also be changes in cell structure in the erythropoietic cells, including membrane convolutions adjacent to vacuoles which lack organelles or any organized structure suggesting an effect of alcohol on the cell membranes (Lindenbaum., 1987).
More On Effects of Ethanol in Blood Cells and Bone Marrow.
Megakaryocytes, the precursors of platelets are typically normal or increased in number in the bone marrow of alcoholics (Lindenbaum., 1987), and a low platelet count is a common finding after heavy ethanol intake. Rebound thrombocytosis (an elevated platelet count) usually occurs within a week of alcohol withdrawal.
It has been postulated that alcohol intoxication itself is the cause of thrombocytopenia, but it is likely that the mechanism is a combination of ineffective thrombocytopoiesis (normal in the presence of increased numbers of marrow megakaryocytes with decreased production of platelets) and a shortened platelet life span (Lindenbaum 1987).