The Hemolytic Anemia of Human Bartonellosis

A study of the processes of formation and destruction of blood has been carried out, in addition to other investigations of the physiopathology of the anemia of human bartonellosis. From the results obtained the following conclusions may be drawn:

1. The life-span of the red cells parasitized by Bartonella bacilliformis is greatly shortened. However, not all the parasitized red cells are prematurely destroyed.

2. Red cells from normal subjects are partially destroyed when they are injected into infected patients. More than 50 per cent of them survive normally.

3. The mechanical fragility of the red cells is increased in the majority of the cases.

4. The index of sequestration of red cells by the liver and spleen was increased in the three patients studied. Also, the products of catabolism of hemoglobin were increased in all the patients studied.

5. The increased production of red cells as a response to the great destruction was prevented at first, but later it reached its peak, being in some cases five times greater than normal.

6. The search for agglutinins and hemolysins was negative.

7. The amount of free protoporphyrins in the red cells was increased, indicating that there was some interference to the synthesis of hemoglobin that would also explain the hypochromia of the red cells.

8. The increase in the diameter of the red cells was independent of the actual amount of reticulocytes.