Hemolytic anemia and susceptibility to hydrogen-peroxide hemolysis in children with vitamin E-deficiency and chronic liver disease.
Thirty-four children, aged 1-14 years, with severe chronic liver disease were studied to determine the incidence of chronic hemolytic anemia and the mechanism underlying it. Sixteen children were grouped as vitamin E-deficient patients (Group I, serum vitamin E level below 5.0 micrograms/ml) and compared with 18 vitamin E-sufficient children (Group II) and 20 healthy controls. Group I patients had a significantly lower hemoglobin level (11.6 +/- 0.4 g/dl) when compared with Group II (12.9 +/- 0.4 g/dl, less than 0.05), their RBC's were less resistant to H2O2-induced hemolysis (53.1 +/- 8.0% in Group I, vs. 1.07 +/- 0.23% in Group II), and the average hemolysis correlated with serum vitamin E levels. H2O2-induced hemolysis reverted to normal in five patients after vitamin E therapy. With respect to controls, cirrhotic children in both groups showed a slight increase in total RBC membrane lipids, but no difference in either phospholipid content or in cholesterol/phospholipid molar ratio that could have changed RBC membrane properties and sensitivity to lysis. In our experience, vitamin E-deficient cirrhotics have a slight degree of chronic hemolytic anemia and their RBC's are much more sensitive to H2O2 lysis, although this abnormal lysis susceptibility does not seem apparently related to membrane peroxidation.
Fernández-Zamorano
A
A
Department of Laboratory and Child Health, La Paz Hospital, Facultad Autónoma de Medicina, Madrid, Spain.
Arnalich
F
F
Codoceo
R
R
Vigara
M R
MR
Valverde
F
F
Jara
P
P
Vázquez
J J
JJ
D000293:Adolescent; D000743:Anemia, Hemolytic / Q000097:blood / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004198:Disease Susceptibility; D004910:Erythrocyte Membrane / Q000378:metabolism; D006461:Hemolysis / Q000187:drug effects*; D006801:Humans; D006861:Hydrogen Peroxide / Q000494:pharmacology*; D007223:Infant; D050356:Lipid Metabolism; D008055:Lipids / Q000097:blood; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008111:Liver Function Tests; D010084:Oxidation-Reduction; D014811:Vitamin E Deficiency / Q000097:blood / Q000150:complications* / Q000503:physiopathology
D008055:Lipids; D006861:Hydrogen Peroxide