Roentgenographic bone changes in chronic iron deficiency anemia. A study in twelve patients.

B ONE CHANGES similar to those occtirring in Cooley’s anemia and ohserved in chronic iron deficiency anemia were first described by Reimann in 1956.’ He noted striking alterations, particularly in the skull and also in short and long bones, due to erythroid hyperplasia of the bone marrow. According to Reimann, these changes were never so pronounced as in Cooley’s anemia. In 1958 Eng described bone changes in the skull of a 12-year-old Indonesian girl with chronic iron deficiency anemia.2 The skull changes very much resembled those found in Cooley’s anemia or related congenital hemolytic anemias. Following Eng’s communication, several reports appeared describing bone changes confined to the skull, similar to those found in Cooley’s anemia. For instance, in 1960 Shahidi and Diamond reported skull changes in three infants with iron deficiency anemia, and Britton et al. described skull changes in five children.1’4 In addition to these, in 1961 Moseley reported skull changes in a 3year-old Puerto Rican boy,5’” and Burko and his associates described seven Negro children with similar skull alterations.7 Prasad et al. described a syndrome of iron deficiency anemia, hepatosplenomegaly, hypogonadism, dwarfism and geophagia in 11 males from Iran.8 Some of these patients also showed skull alterations similar to those described above.