The Hydrogen Peroxide Fragility Test and Serum Tocopherol Level in Anemias of Various Etiologies

Increased in vitro erythrocyte sensitivity to the hemolytic effects of hydrogen peroxide (H₂O₂) in the H₂O₂ fragility test has been widely associated with vitamin E deficiency. In the present study, H₂O₂ red cell fragility was abnormally elevated in many types of acquired and congenital anemias in children who were tocopherol sufficient. In addition to abnormal red cell H₂O₂ sensitivity known to occur in vitro in conditions involving defects in cellular devices for disposal of peroxides, it is likely that a wide variety of erythrocyte dysfunctions result in increased in vitro H₂O₂ hemolysis even in situations where the usually adequate mechanisms for peroxide detoxification are present.