Iron deficiency and sickle cell anemia.
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 degrees C (P50), indicating an increased oxygen affinity. These data suggest that a reduction of the MCHC induced by iron deficiency may ameliorate sickling.
D000747:Anemia, Hypochromic / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D000755:Anemia, Sickle Cell / Q000097:blood / Q000150:complications*; D001424:Bacterial Infections / Q000150:complications; D005293:Ferritins / Q000097:blood; D005296:Ferrous Compounds / Q000627:therapeutic use; D006441:Hemoglobin A / Q000032:analysis; D006451:Hemoglobin, Sickle / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011183:Postoperative Complications
D005296:Ferrous Compounds; D006451:Hemoglobin, Sickle; C020748:ferrous sulfate; D005293:Ferritins; D006441:Hemoglobin A; D010100:Oxygen