Which hematological abnormality is often seen in alcoholics?

In individuals with chronic alcohol use, macrocytic anemia is frequently observed. This type of anemia is characterized by the presence of larger-than-normal red blood cells. Alcohol affects the absorption of key nutrients, particularly folate (vitamin B9) and vitamin B12, which are crucial for proper red blood cell formation. Folate deficiency is particularly common in alcoholics due to poor dietary intake and impaired absorption, leading to impaired DNA synthesis. As a result, the red blood cells become larger in size due to ineffectual hematopoiesis (the formation of blood cells) and increased cell volume.

In addition to affecting nutrient absorption, alcohol can also lead to liver dysfunction, which can contribute to macrocytic anemia by impairing the production of substances necessary for normal red blood cell development. These mechanisms make macrocytic anemia a definitive hematological abnormality associated with chronic alcohol abuse.