Free Erythrocyte Porphyrin and Plasma Copper in Rheumatoid Disease

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Abstract
Free erythrocyte protoporphyrin was increased in 14 of 50 cases of active rheumatoid arthritis. The level was unrelated to duration or activity of the disease. There was an inverse relationship to hemoglobin and plasma Fe, but not to plasma Cu. Porphyrin values regularly became normal after adequate Fe therapy. The raised prophyrin values were due to Fe deficiency, and not to the rheumatoid disease. Plasma Cu concentration was raised in 77 of 100 cases, the increase being related to the degree of anemia. Plasma Cu was not related to disease activity or length of illness. In 15 cases the plasma copper showed no consistent change during Au therapy. During intravenous Fe therapy, plasma Cu usually increased; elevated values were still present 3 months after therapy, even though the hemoglobin had risen to normal. It appears that the hypercupremia observed in rheumatoid disease is only partly explained by the presence of anemia.