Radioactive iron studies in patients with iron deficiency anemia with concurrent abnormal hemolysis.

By sI. C. VERLOOP, M. VAN 1)ER WOLK AND A. J. HElEn O CCASIONALLY patients with hyj)ochronlic anemia and signs of iron deficiency are encountered who show suboptimal response to iron a iniinistration. A pOssii)le cause of this is blood loss, including the loss of blood! illtO organs, IS in pulmonary hemosiderosis. In the absence of bloodi loss, tile CUtlS#{128} may be a disturi)ance in iron absorption from the gastrointestinal tract. Infections, too, can have an unfavorable effect on iron incorporation in hemoglobinopoiesis; the same holds true for vitamin C deficiency ( Parsons and Car Small vood2 ) . In the absence of such changes, it is more difficult to discover the cause of poor response to iron thera )y. Zetterstr#{246}m and Delava diescrihed two children vith hy1)ochromic anemia and a low serum iron concentration, refractory to iron therapy. There was no steatorrhea, but the absorption of radioactive iron was insufficient. Intravenously given radioactive iron, moreover, was poorly utilized in hemoglobinopoiesis. No signs of abnormal hemolysis were found. \Ve have had! occasion to exauhine two adult women with severe anemia who showed, besides signs of iron dieficiency, a markedly reduced life-span of their red cells. Transfused normal red cells, moreover, disappeared from the circulation rapidly. In these patients, extracorpuscular factors in organs or plasma seemedi to cause abnormal hemolysis.