THE ANEMIA OF INFECTION. XX. THE KINETICS OF IRON METABOLISM IN THE ANEMIA ASSOCIATED WITH CHRONIC INFECTION 1

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Abstract
Plasma and red cell iron turnover studies were carried out on 6 patients with the anemia of infection and on 10 normal subjects. Body-surface counts were made with a mobile scintillation counter over the liver, spleen, and sacral bone marrow sites in 2 patients and in 2 control subjects. The average half time of plasma Fe59 disappearance in the patients was 0.51 hours as compared with 1.39 hours in the control subjects. Average plasma iron turnover rate and red cell iron turnover rate in patients was 0.61 mg/kg/day and 0.58 mg/kg/day, respectively as compared with 0.56 mg/kg/day and 0.52 mg/kg/day in normal subjects. Incorporation of Fe59 into the red cells of patients was initially more rapid than in control subjects. The ultimate percentage of injected Fe59 incorporated into erythrocytes was the same in both groups. The average "apparent" erythrocyte life span, as calculated from the above data, was significantly shorter in patients than in control subjects. The body-surface counting patterns of uptake and delivery of Fe59 by the liver, spleen, and bone marrow in the patients with infection did not differ significantly from those in the normal subjects. Very little activity entered the liver or spleen. Data suggest that the erythrocyte life span in patients with chronic infection is shortened. However, the bone marrow is unable to compensate for this modest shortening of the erythrocyte life span. When consideration is given to the fact that a normal marrow is capable of increasing its production 6 to 8-fold, it is apparent that there is marked inhibition of erythropoiesis in such patients.