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Iron Deficiency and Sickle Cell Anemia

Koduri R. P. Rao, MD; Ashok R. Patel, MD; George R. Honig, MD; Loyda N. Vida; Patrick R. McGinnis, MD
Arch Intern Med. 1983;143(5):1030-1032. doi:10.1001/archinte.1983.00350050194038.
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• In a patient with sickle cell anemia, iron deficiency was accompanied by hypochromic, microcytic RBCs, absence of bone marrow iron, and a low serum ferritin level. The mean corpuscular hemoglobin concentration (MCHC) was decreased (27.6 g/dL) and was associated with an extreme scarcity of sickled erythrocytes in blood smears. Iron therapy resulted in reticulocytosis and an increase in sickled erythrocytes. In vitro studies demonstrated a decrease in sickling of erythrocytes as a function of oxygen saturation of the blood when the patient was iron deficient. The whole blood oxygen dissociation curve showed a substantial decrease in oxygen pressure necessary to produce 50% saturation of hemoglobin at pH 7.4 and 37 °C (P50), indicating an increased oxygen affinity. These data suggest that a reduction of the MCHC induced by iron deficiency may ameliorate sickling.

(Arch Intern Med 1983;143:1030-1032)


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