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Porotic Hyperostosis in the Eastern Mediterranean

Abstract

Porotic hyperostosis is bone expansion caused by hypertrophy of blood-forming marrow. It usually affects the skull diploë in adults and the long bones, face, skull vault, and sometimes the trunk in children, often with some thinning and porosity in the cortex and even the formation of a double cortex (bone-in-bone) in severe infections. Excess formation of red cells in hematogenous marrow can come from sicklemia or thalassemia (especially in the homozygous form), from other hemolytic anemias including unusual blood defects like spherocytosis, and from iron deficiency anemia. Presumably hookworm, amebiasis and other dysenteries, endemic malaria, and even high-altitude anoxia can produce enough anemia to expand the bone marrow space in some people, though there is no detailed evidence for this

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