Refractory sideropenic anemia in childhood due to an error of iron metabolism.

By R0LF ZEVrERSTR#{246}M AND SIMONE DELAVA I N SO?s’IE earlier reports indications have been put forward that pure hypochronsic amiemia might develop in the absemice of nutritiomial deficiency or bleedimig. Iii an extemisive study on hereditary hypochromic amiemia occurring in a district in the northern part of Sivedemi, Lundholm’ concluded that the cause of the anemia was an increased demand of iron. Whems the patients were treated svith high doses of iron by mouth the amiemia improved. Although this is an imidication that defective iron absorption might be the cause of hypochromic amicmuia, cases with proved complete refractoriness to peroral treatmemit with iromi have never l)eemi reported except in association with steatorrhea.2 In such mefractory cases which have been studied with reference to fat absorption it has always been found to be defective. In this commuunication, one case ivith a completely refractory primary sideropenic aneniia, and amiother with poor response to iron therapy will be reported. In both cases there were imidications that the anemia was not omily caused by poor iron al)sorption from the gastro-intestinal tract, but to a more generalized disturbance of iron metabolism which was not secondary to infection or other disease. The features of this special type of hypochromic anemia will be discusse(l with reference to the results obtaimied when studying the iron metabolism by nieans of radioiromi.