Large numbers of Howell-Jolly bodies were found in the bone marrow and peripheral blood, both before and after corrective haematinic therapy, in three patients with idiopathic steatorrhoea with associated splenic atrophy, who presented with megaloblastic anaemia. The proportion of erythrocytes containing Howell-Jolly bodies was much higher in these patients when compared with the number found in post-splenectomy subjects. Red cell survival studies of patients' own red cells, sensitized with a potent anti-D serum, showed an abnormally prolonged survival in the three patients with splenic atrophy when compared with those in two splenectomized subjects, in four patients with coeliac disease, and in seven normal controls. There appears to be a relationship between atrophy of the reticuloendothelial system and Howell-Jolly body production in idiopathic steatorrhoea.
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