Mechanisms of Hemolysis in Iron Deficiency Anemia. Further Studies

Red blood cell survival time as measured with ³²DFP and ⁵¹Cr was studied in subjects with iron deficiency anemia associated and nonassociated with hook-worm infection. ⁵¹Cr T ½ was definitely shorter in all cases in which ³²DFP showed marked excess hemolysis, but a normal ⁵¹Cr T ½ was found in some cases in which ³²DFP survival was slightly reduced.

There was a high correlation between survival measured with ³²DFP and the rate of abnormal red cells in the peripheral blood. Less correlation was found between the proportion of hypochromic microcytic red cells and ³²DFP, and even less correlation, although significant, was observed when ⁵¹Cr T ½ was compared with the red cell parameters.

Results of the red cell survival studies with erythrocytes from subjects with iron deficiency anemia injected into the donor subject, normal recipients, and splenectomized subjects, as well as body ⁵¹Cr surface countings, indicated that excess hemolysis in this type of anemia is due to an intrinsic defect of the red blood cells and that the spleen is the principal sites of destruction of these cells.