A double tracer study on iron metabolism and red cell life span in various diseases using radioactive iron and chromium

Han, M C

Abstract

A double tracer study on erythrokinetics was carried out with radioactive iron (Fe59) and chromium (Cr51) in 42 patients having various diseases; 10 with iron deficiency anemia, 9 with aplastic aneia, 12 with leukemias and 11 with liver cirrhosis acompanied by splenomegaly. The sites of the red cell production and destruction were determined with the body surface counting techniques. The true blood volume was calculated and the whole body hematocrit correction factor was also evaluated. Following were the results; 1. In iron deficiency anemia, all of the plasma iron disappearance, plasma iron turnover, red cell iron utilization, red cell iron turnover, and the red cell iron renewal rate were accelated. A markedly increased bone marrow erythropoiesis was observed and the red cell life span was in normal limits. 2. In aplastic anemia, the plasma iron disappearance as prolonged whilethe plasma iron turnover was normal or slightly increased due probably to a relative increase of the plasma volume and high plasma iron level. The red cell iron utilization, red cell iron turnover and the red cell renewal rate were decreased. A markedly decreased erythropoiesis in the marrow with an increased extramedullary erythropoiesisin the liver was observed. The red cell life span was shortened than normal, especially in patients with bleeding tendency. 3. In leukemia, there existed no specific pattern according neither to cell types nor to the time of onset. The case of anemia in this disease seems to be a decrease in the marrow erythropoiesis or an increase of the red cell destruction with the shortened red cell life span or the combination of the both. 4. In liver cirrhosis with splenomegaly, the plasma iron turnover, red cell iron utilization, red cell iron turnover and the red celliron renewal rate were increased. The marrow erythropoiesis was increased than normal, but a markedly increased red cell destruction in the enlarged spleen was observed. The red cell life span was shortened than normal,especially in patients with bleeding tendency. 5. The hematocrit correction factor in patients without splenomegaly was normal while it in patients with splenomegaly was increased by about 12%. The hematocrit correction factor does not appear to be correlated with the affected disease but with degree of splenomegaly.