Giant Myeloid Cells in the Bone Marrow of Protein Malnourished Infants: Relationship to Folate and Vitamin B₁₂ Nutrition

Abstract

FRANK niegaloblastic anaemia is well recognized in protein malnourished infants (Altniann

Ultrastructure and cell cycle distribution of bone marrow cells in protein-energy malnutrition

“…That there is some disturbance of haemopoiesis in PEM is :\: Based on results from four normal volunteers and eight haematologically normal patients. §From Wickramasinghe also indicated by the presence of megaloblasts and giant metamyelocytes in some cases of PEM (Adams et al 1967;Spector & Metz 1966;Fondu et al 1973;Wickramasinghe et al 1983a), by the demonstration of decreased lysozyme activity in the leucocytes of children with kwashiorkor (Mohanram, Reddy & Mishra 1974), and by the fact that the bone marrow cells of some patients with PEM give abnormal deoxyuridine (dU)-suppressed values which appear not to be related to folate or vitamin B I 2 deficiency but to some consequence of the protein deficiency (Wickramasinghe et al 1983a,b). However, since there is no correlation between the haemoglobin levels of children with PEM and the dUsuppressed values given by their marrow cells, it seems that the impairment in the methylation of deoxyuridylate does not limit the rate of effective erythropoiesis (Wickramasinghe et al 1985a).…”

“….... l::l l::l dyserythropoiesis and ineffective erythropoiesis in the pathogenesis of the anaemia of PEM, we studied the ultrastructure of the erythroblasts and bone marrow macrophages and the cell cycle distribution of the erythroblasts in seven Nigerian children with kwashiorkor or marasmus. Since some giant metamyelocytes are present in a substantial proportion of patients with PEM (Spector & Metz 1966;Wickramasinghe et at. 1983a), we also studied the ultrastructure and cell cycle distribution of granulocytes and their precursors in the marrow aspirates of our cases.…”

Nutritional Anaemias

“…\\'e now favour the name nutritional megaloblastic anaemia for this group and we know that the common denominator is folic acid deficiency. 'Ve can probably add other chronic infect ions as contributing factors; possihlv infection blocks the function of folic acid in uucleo-protein synthesis (Spector & Metz 1966) much as it interferes with the incorporation of iron into haemoglobin. But Wills's definition is an apt one for it clearly shows how broad-based the condition is and how it merges with better recognized entities such as megaloblastic anaemia of pregnancy.…”