A Study in Bone Marrow Changes Found in Severe Anaemia Commonly Associated With Ankylostomiasis

MacGregor, George Alistair (1946) A Study in Bone Marrow Changes Found in Severe Anaemia Commonly Associated With Ankylostomiasis. MD thesis, University of Glasgow.

Abstract

1. Attention is drawn to the customary type of hospital treatment received by the poorer type of East African native suffering from ankylostomiasis and to his impoverished physical and nutritional background. 2. The prevailing type of diet used by the poorer native is outlined together with some remarks on his economic status. The clinical features of the 16 cases of severe anaemia comprising the body of this thesis are presented in detail. 4. The technique used for peripheral and sternal marrow examin- ations is outlined. 5. The terminology followed in this thesis is detailed, and emphasis is placed upon the difficulty of differentiation between certain cells of the early normoblastic and megaloblastic series. 6. The peripheral blood findings of the 16 cases together with their concomitant pathological conditions are discussed in detail, and the possible role played by malaria, sepsis, filariasis, mossy foot and avitaminosis (A) in the production of the severe anaemia present,is mentioned. 7. The sternal marrow findings are considered qualitatively, and the outstanding impressionsderived from their study are (a) the irregularity of maturation of the erythrocyte, (b) the irregularity of haemoglobinisation, and (c) the dimorphic character of the anaemia, i. e. , the marrow exhibits a mixed normoblastic and megaloblastic reaction. 8. The tendency to overlook the possibility of a mixed normo- blastic and megaloblastic marrow, if too much reliance is placed on the colour index and on the peripheral blood find- ings only, is emphasised. 9. Attention is drawn to the fact that the fundamental pathological basis of this mixed normoblastic and megaloblastic anaemia is a nutritional deficiency or deficiencies, and that the superimposition of such conditions as malaria, pregnancy, ankylostomiasis and other debilitating diseases throws an excessive strain on an already too delicately poised erythropoietic system, so much so that it breaks down and the resulting abnormal erythopoiesis may take the form either of a mixed normoblastic and megaloblastic reaction or of a frank megaloblastic reaction. 10. The nature of the nutritional deficiency or deficiencies responsible for the dual nature of the anaemia is discussed, and reference is made to the possible link up between the factor isolated by Wills from crude liver extract, the factor (so far not identified) in the dried hog's stomach used in pellagrins by the Gillmans in South Africa, and folic acid synthesised by Spies and his collaborators and used so effectively in macrocytic anaemias in America.

• Item Type: Thesis (MD)
• Qualification Level: Doctoral
• Keywords: Medicine, Epidemiology
• Date of Award: 1946
• Depositing User: Enlighten Team
• Unique ID: glathesis:1946-79619
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 04 Mar 2020 16:37
• Last Modified: 04 Mar 2020 16:37
• URI: https://theses.gla.ac.uk/id/eprint/79619