The Occurrence of Megaloblastic Erythropoiesis in Patients with Hemochromatosis

The occurrence of megaloblastic anemia in hemochromatosis was observed in 9 patients. The anemia was characterized by a macromegalocytic blood picture, a hyperactive macromegaloblastic erythropoiesis as well as a positive response to liver therapy. The bone marrow reticulum was hyperplastic and showed extensive hemosiderin phagocytosis. The hemosiderin was also stored in the plasma cells. This unusual finding was pathognomonic for megaloblastic anemia of hemochromatosis and distinguishes it from the other symptomatic megaloblastic anemias.

Megalocytic anemia occurs relatively frequently in hemochromatosis. Pigment cirrhosis of the liver and hemosiderotic changes in the gastro-intestinal tract seem to be responsible for its genesis. Disturbance in storage, absorption and formation of the antianemic principle favors the accompanying hematologic changes.