Blood, 1960, Vol. 15, No. 5, pp. 791-806.
© 1960 American Society of Hematology, Inc.
Radioactive Iron Studies in Patients with Iron Deficiency
Anemia with Concurrent Abnormal Hemolysis
M. C. VERLOOP 1,
M. VAN DER WOLK 1, and
A. J. HEIER 1
1 Hematological Laboratory, Geneeskundige Universiteitskliniek, Utrecht (Netherlands).
A report is presented on two women suffering from severe iron deficiency
anemia, concomitant with abnormal hemolysis. The life span of the patients
red cells was shortened; transfused normal red cells were more rapidly
broken down. Extracorpuscular factors seem to be responsible for the pathologic hemolysis. There was no pathologic sequestration of red cells labeled
with Cr51 in the spleen.
After incorporation of radioactive iron into the red cells, the utilization
percentage of Fe59 under iron therapy fell to about 15 per cent within a few
weeks. This, too, indicates that the pathologic hemolysis was to be ascribed
to extracorpuscular factors. The Fe59 was apparently not sufficiently reutilized.
The constantly decreased serum iron concentration might also indicate a
disturbance in the reutilization of iron liberated during red cell breakdown.
Six other patients with less severe iron deficiency anemia and an insufficient
response to iron therapy were examined in addition. In 5 of these patients,
the life span of red cells labeled with radioactive chromium was found shorter
than normal. An insufficient response to iron therapy in patients with chronic
iron deficiency anemia may be ascribable, in some instances, to concomitant
pathologic hemolysis.