BERTRAM SCHNITZER, M.D.
To the editor: I should like to comment and expound on the editorial "Analgesics, Hemolysis, and Splenomegaly" (ANNALS, April 1971). Although phenacetin has been implicated as the agent responsible for nephropathy and hemolytic anemia, our studies in rats showed that phenacetin itself does not cause the Heinz body hemolytic anemia, the methemoglobinemia, the sulfhemoglobinemia, and the prominent enlargement of the spleen (1, 2). Para-chloroacetanilide (acetic-4-chloranilde), a contaminant in phenacetin, caused Heinz body formation, hemolysis, and a tenfold enlargement of the spleen, whereas high doses of phenacetin (in which a minute amount of contaminant was present) caused only mild changes (1).
SCHNITZER B. Analgesics, Hemolysis, and Splenomegaly. Ann Intern Med. ;75:320–321. doi: 10.7326/0003-4819-75-2-320_2
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Published: Ann Intern Med. 1971;75(2):320-321.
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