Evaluation of the anemia of rheumatoid arthritis.

MONG THE PROBLEMS often confronting the physician treating patients with rheumatoid arthritis is a recalcitrant anemia.’3 It tends to be hypochromic and normocytic, and in many respects it resembles the anemia associated with chronic infection. The patient with rheumatoid arthritis often responds poorly to orally administered iron. A number of studies have been carried out and various conclusions reached regarding the etiology of the anemia, as reviewed by Weinstein.4 In his own unusually thorough study, Weinstein was unable to pinpoint any specific primary abnormality to account for the anemia. We have re-investigated the problem in a population of patients having active rheumatoid arthritis but little anemia. The thought was that changes in the preanemic period might furnish clues which would be masked by the anemic stage.