Figure 1.

Causes of anemia in alcoholics. Alcohol, as well as alcohol-induced cirrhosis, leads to decreased red blood cell (RBC) production. Hypersplenism, a condition characterized by an enlarged spleen and deficiency of one or more blood cell types, can induce premature RBC destruction. Blood loss occurs primarily in the gastrointestinal tract (e.g., at the sites of peptic ulcers) and is increased in patients with reduced platelet numbers. Folic acid deficiency impairs RBC production and results from decreased ingestion, decreased absorption, and abnormal metabolism of folic acid.

SOURCE: Adapted with permission from Cornwell, G.G., III. Hematologic Complications of Alcohol. Unit 3. Developed by the Project Cork Institute at Dartmouth Medical School. Timonium, MD: Milner-Fenwick, 1981.