Some observations on the morphology of erythropoietic cells in human lead poisoning.

LTHOUGII MUCH HAS BEEN WH1TTEN 55l)OUt the blood muorphology an(1 blood chemuistry its lead poisonimig, the (Flanges in the bomie marrow have received comparatively little (omisideratiomi. So far as we cams aseertaims, the literature up to date contaimss 20 papers’2#{176} deahimig in variouS ‘ays with the bone marrow iii humnan lead poisoning, but relatively few observers5 ‘ . “ . ‘ . ‘9 have had an opportunity of studyimig miiome than two os three isolated cases. i\loreover imi omily six reports5’ 7. 9. mi tfi. m7 has the diagusosis of lead poisomlimig beemi verified by laboratory data (lead in blood om ims excreta and ‘or pomphynimiumia). Most clinical observers’’ 2, 46, 9. tt. 12. 14, 16, 19 give data showitig the relative frequencies of myeloid leukocytes and erythroblasts imi the mnarrow of intoxicated patients. While some of them also outline the presence of stippled erythrocytes, others7’ 8, 10, 13, ii, 58 have merely been comieerned with their occurrence in the bone marrow. A small number of papers have dealt with qualitative changes affecting ervthropoietic cells in lead poisonimsg. Thus, nuclear chamsges, maimsly (lemloted as “karyorrhexis,” have been observed by Cadwalader2, Dc Weerdt6, Leitmier’4 amid Rohr,’9 stippled erythroblasts have been reported by De Weerdt, Movitt , Saita,’6 and McFadzean and Davis.18 I)eviatioms of normuopoiesis has been also mioted: Pellegrimsi3 found megaloblastic hemuopoiesis, Pelaez-Redomsdo” noted “sotue forms with megaloblastic tendemicy,” Gart&7 memitiomsed mnaerocyt ic hsemuopoiesis, amid Heilmeyer2#{176} observed “erythroblasts similar to megaloblasts.” Kienle’2 called attention to the atypical mitoses in lead poisonimig. With the exception of two reports’2 18 there are, however, no detailed descniptiomis amid illustrations of all these changes. In a study on bone mnarrow changes in lead poisonimig amid its abnonmual lead absorption which has been carried out at this Imsstitute dunimig the last 8 years, we have found (1) predomimiance of eryt.hrocytogemiesis as evidenced by a low myeloid-erythroid ratio, and (2) certaimi qualitative changes, iii all cases of manifest lead poisoning. The present report is a part of the study comprising only qualitative changes of erythropoietic cells. Statistical data concerning the cellular composition of boise misarrow cells amid the imicidente of ssbnommal cells will be published elsewhere.