Blood, 1953, Vol. 8, No. 6, pp. 502-518.
© 1953 American Society of Hematology, Inc.
Some Observations on Anemia in Rheumatoid Arthritis
M. R. JEFFREY M.D., M.R.C.P.1
1 Rheumatism Research Unit of the South West and Oxford Regions, Royal
National Hospital for Rheumatic Diseases, Bath, England.
1. The results of investigations upon some aspects of anemia in rheumatoid
arthritis are reported and discussed.
2. The anemia was essentially normocytic and hypochromic, the mean corpuscular volume being usually normal and the mean corpuscular hemoglobin
content and concentration usually reduced. Anemia was more pronounced in the
presence of very active disease.
3. Undue hemolysis was not of importance.
4. The myelogram showed no gross abnormality but suggested impaired
maturation of normoblasts and retarded hemoglobin formation.
5. The blood and plasma volumes were not essentially abnormal, though
the frequent asthenic habitus and loss of weight might produce apparently
exalted values in terms of body weight. In the more anemic cases, changes common to many anemias were found, viz., normal plasma volume with decreased
corpuscle and whole blood volume.
6. The plasma iron concentration was usually reduced; subnormal values were
invariable in cases with very active disease or marked anemia.
7. The iron-binding capacity of the serum might be raised by iron deficiency
or slightly reduced but not enough to be a factor in producing or maintaining
anemia.
8. As judged by changes in the plasma iron, intestinal absorption of iron
after a single maximal therapeutic dose was variable. Some cases showed the
excellent absorption and therapeutic response characteristic of simple iron deficiency. Others gave strong presumptive evidence of impaired absorption.
Submitted on May 16, 1952
Accepted on January 27, 1953
