Abstract
Studies on the mechanism of acute anemic crisis in autoimmune hemolytic anemia (AIHA) demonstrated two kinds of crisis, acute hemolytic and acute aplastic. Erythroblasts in the bone marrow decreased slightly in acute aplastic crisis, but they remained with in normal limits. Circulating reticulocytes decreased markedly in spite of the slight reduction of erythroblasts. This suggests a marked increase of ineffective erythropoiesis in acute aplastic crisis.
The erythropoietic efficiency of bone marrow was determined on 7 patients with AIHA by modified Haurani's method. It was within normal limits in two of 7 cases. It decreased in 5 cases, indicating the increased ineffective erythropoiesis in these cases.
Electronmicroscopic examinations on bone marrows of patients with AIHA demonstrated frequent phagocytosis of erythroblasts and red cells by reticulum cells.
The antigen antibody reaction between incomplete autoantibodies of AIHA and bone marrow cells was confirmed by the indirect anti-globulin comsumption test.
These results suggest that an increased abortion rate of erythroblasts caused by incomplete autoantibodies has great significance in the mechanism of the increased ineffective erythropoisis in AIHA.
