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JR Feussner, JD Shelburne, S Bredehoeft and HJ Cohen
A patient with severe arsenic poisoning that resulted in marked peripheral
blood and bone marrow abnormalities, including megaloblastic erythropoiesis
experienced many of the previously reported hematologic complications of
arsenic poisoning: leukopenia, granulocytopenia, absolute eosinophilia, and
profound anemia. In this study we report an ultrastructural and
electron-probe analysis of the bone marrow. Although megaloblastic anemia
associated with arsenic poisoning has been described rarely, the presence
of arsenic in the local bone marrow milieu has not been demonstrated
previously. The ultrastructural features of arsenic-induced bone marrow
toxicity are similar to those described in other dyserythropoietic states
and include marked nuclear aberrations involving shape, chromatin
distribution, and nuclear envelope. Using the technique of
energy-dispersive x-ray analysis (electron probe) we demonstrated arsenic
in bone marrow spicules; this supports the contention that arsenic can
cause megaloblastic anemia. We suggest that this technique may be a useful
tool in further studies that attempt to explore the mechanism of
arsenic-induced hematologic toxicity. Finally, we suggest that arsenic has
a direct toxic effect on DNA synthesis that results in marked disturbances
of nuclear division. We recommend that the most appropriate screening
procedure to evaluate possible arsenic poisoning is tissue arsenic
measurements (hair and nails) rather than 24-hr urinary measurements.
This article has been cited by other articles:
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| Copyright © 1979 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
