ENZYMES IN ANEMIA: A STUDY OF ABNORMALITIES OF SEVERAL ENZYMES OF CARBOHYDRATE METABOLISM IN THE PLASMA AND ERYTHOCYTES IN PATIENTS WITH ANEMIA, WITH PRELIMINARY OBSERVATIONS OF BONE MARROW ENZYMES

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Abstract
The enzymes phosphohexoisomerase (PHI), aldolase (Aid,), lactic dehydro-genase (LD), malic dehydrogenase (MD), isocitric dehydrogenase (ICD), glucose-6-phosphate dehydrogenase (G-6-PD) and 6-phosphogluconic dehydrogenase (6-PGD) were assayed in erythrocytes and the plasma of patients with megaloblastic anemia, sickle cell anemia and other hemoglobinopathies, blood loss anemia, thalassemia, hypoplastic anemia and other anemias. There was a marked increase in the plasma enzyme levels, especially LD and MD, in megaloblastic anemia; in sickle cell anemia these enzyme levels were less markedly increased. In blood loss anemia they were normal. Only a minor increase in enzyme concentration was found in the erythrocytes in megaloblastic anemia, sickle cell anemia and blood loss anemia. Enzyme assays in bone marrow buffy layer and bone marrow plasma revealed higher levels of all enzymes in megaloblastic bone marrows than in normo-blastic ones. These findings support the hypothesis that the enzyme elevations in the peripheral plasma in megaloblastic anemias reflect increased enzyme concentrations and increased intramedullary cell tur nover.