Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders?

ALD (alcohol liver disease) is a condition that can result in anemia, clotting disorder and other problems.

1. Anemia: Alcoholism can result in a shortage of essential nutrients like folic, B12, iron and vitamin C, all necessary to produce red blood cell. Alcohol can also damage the bone marrow where red cells are made, resulting in a decrease in the production of red blood cells. Chronic liver diseases can cause a decrease in the amount of erythropoietin (a kidney hormone that promotes red blood cell production).
2. Clotting disorders. The liver is the source of many blood-clotting proteins, including fibrinogen (a protein), prothrombin and clotting Factors II, VI, VII, VIII, and IX. Chronic alcohol abuse damages the liver and can reduce production of these factors. In addition, excessive alcohol consumption can lead to an imbalance in procoagulant/anticoagulant factor production, which increases the risk of developing clotting diseases such as stroke, deep vein embolism or pulmonary embolism.
3. Alcohol abuse that is chronic can cause platelet counts to drop, resulting in thrombocytopenia. It can also increase bleeding risk, particularly in the digestive tract. Patients with liver diseases are already at a higher risk due to the increased pressure on the portal vein.

Chronic alcohol abuse, through liver damage and imbalances of clotting factor, can lead to anemia, bleeding disorders and thrombocytopenia. The hematologic conditions can lead to complications for patients who have alcoholic liver diseases. Early detection and treatment of these disorders is crucial in order to achieve optimal outcomes.