The iron content of gastric juice: in relation to the cause of idiopathic hypochromic anemia.

Non-hemin iron content in gastric juice was examined in 46 patients with various blood diseases, especially idiopathic hypochromic anemia and in 26 healthy controls. 1. The iron content in gastric juice was found to be 290 μg/ dl in healthy controls, a lower value of 110 μg/ dl in idiopathic hypochromic anemia and a higher value of 550 μg / dl in aplastic anemia. These values were in a close correlation with serum iron or sideroblasts. 2. In idiopathic hypochromic anemia there was also a close correlation between the iron content in gastric juice and hemoglobin. In the course of treating idiopathic hypochromic anemia (stage of recovery of anemia) the iron content in gastric juice showed a marked increase over the value in healthy controls as well as a transient increase after an intravenous iron tolerance test. This condition may be interpreted as an “iron-losing anemia”. Iron excretion of gastric mucosa in various blood diseases and its changes in the course of treating idiopathic hypochromic anemia in relation to the cause of this anemia were discussed. ∗PMID: 4230849 [PubMed indexed for MEDLINE] Copyright c ©OKAYAMA UNIVERSITY MEDICAL SCHOOL Acta Mee!. Okayama 21, 177-183 (1967) THE IRON CONTENT OF GASTRIC JUICE: IN RELATION TO THE CAUSE OF IDIOPATHIC HYPOCHROMIC ANEMIA Ikuro KIMURA and Masatoshi YAMANA Department of Internal Medicine, Okayama University Medical School, Okayama, Japan (Director: Prof. K. Hiraki) Received for publication, July 22, 1967 During the last three decade extensive studies on the iron metabolism have been made by various authors revealing that the iron is mainly absorbed through the duodenal mucosa. And in 1963 CROSBY and associates reported that the intestinal mucosa is also responsible for the excretion of iron. Keeping this in mind the authors observed the iron contents of the duodenal mucosa of biopsy specimens obtained from the anemic patients, and it has been demonstrated that there is a close relation between the contents of nonhemin iron of the duodenal mucosa and the general iron metabolism, i. e. the iron contents of the mucosa reflected well the serum iron level. Histochemical observation of the mucosa suggested that besides the iron in epithelium the iron in the lamina propria, probably being carried by histiocytic cells, will be somehow correlated to the iron absorption or excretion of the duodenum. The iron contents of the mucosa increased after the intravenous administration of iron and the iron is mainly deposited in the lamina propria as revealed by histochemical observations. This suggests that the increased iron in the mucosa after the parenteral administration is correlated to the excretion of iron as well as the storage of iron to some extent. For the purpose of settling the problem whether or not the gastroduodenal mucosa is actually involved in the iron excretion the authors observed the iron contents of gastric juice before and after parenteral administration of iron. In this paper it is reported that the iron contents of gastric juice of anemic patients of iron deficiency are generally lower than that of non-anemic individuals, but after the treatment of intravenous or oral iron administration, a fairly large amount of iron is excreted from the gastric mucosa of the anemic patients, continuing even in the period where hemoglobin level has recovered to the normal. The data suggested a possibility of an excess iron excretion being responsible for the development of the idiopathic iron deficiency anemia. The abstract of the present paper was presented at the General Meeting of the Japan Hematological Society in 1966. 177 1 Kimura and Yamana: The iron content of gastric juice: in relation to the cause of Produced by The Berkeley Electronic Press, 1967 178 1. KIMURA and M. YAMANA MATERIALS AND METHODS The subjects of the study were consisted of 26 healthy controls and 46 patients with various blood diseases (22 of idiopathic hypochromic anemia, 15 aplastic anemia and 9 of leukemia), totaling 72 cases. Gastric juice was taken on early morning, and the fluid contaminated with bile or food was not used. Exfoliated cells in the fluid were removed by centrifugation. Non-hemin iron content of gastric juice was measured by BriickmannZondek's methodS. Barkan's method was used for serum iron and Kaplan's method° for sideroblasts, the iron containing erythroblasts in the bone marrow. Forty mg of iron as saccharated ferric oxide were employed for the intravenous iron tolerance test. RESULTS Iron content of gastric juice in various blood diseases (Figs. 1, 2) : In healthy controls non-hemin iron content of gastric juice was considerably variable with an average of 290 /1.g/dl. Idiopathic hypochromic anemia showed a decrease in non-hemin iron content of gastric juice with an average value of 110/1.g/dl. The value was higher in cases of aplastic anemia than in healthy controls, showing the value of 550 /tg/ dl. The majority of leukemia cases was in the range of healthy controls. "~I' ..: .. • • Healthy control o 500 1, 000 )lg/dl ._.' . Idiopathic hypochromic~ anemia ": r