Decreased Red Cell Survival Associated With Liver Disease

IT HAS been known for many years that anemia is frequently present chronic liver disease, especially cirrhosis of the liver. The etiology, however, has been obscure and has been the subject of considerable discussion. Since the anemia is often macrocytic type, as first noted by Gram, 1883,1and subsequently confirmed by others,* it was only natural that a deficiency the anti-pernicious-anemia factor be suspected. This explanation, however, has been largely discredited because of the lack of response to liver extract † and because the bone marrow is rarely megaloblastic character.‡ In addition, it has been shown by Schiff and coworkers15that extracts made from cirrhotic livers are able to produce a hematological remission patients with pernicious anemia. In 1904 Bleichroeder first described the occurrence of red bone marrow the femur of patients with cirrhosis and made the statement that in