Paroxysmal Nocturnal Hemoglobinuria "Obscured" by the Presence of Iron Deficiency

Case Studies1 September 1967Paroxysmal Nocturnal Hemoglobinuria "Obscured" by the Presence of Iron DeficiencyHERBERT E. KANN JR., M.D., CHARLES E. MENGEL, M.D., ROBERT L. WALL, M.D., F.A.C.P.HERBERT E. KANN JR., M.D.Search for more papers by this author, CHARLES E. MENGEL, M.D.Search for more papers by this author, ROBERT L. WALL, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-3-593 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn paroxysmal nocturnal hemoglobinuria (PNH) the loss of iron in the urine in the form of hemoglobin or hemosiderin is primarily responsible for the unusually high incidence of iron deficiency that has been observed (1, 2). Although repletion of iron stores may result in significant improvement in the anemia of PNH, therapeutic replacement of iron can also constitute a special problem in this disease since iron administration may accelerate hemolytic activity (1, 3).This relationship between iron and PNH hemolytic activity was demonstrated in a patient whom we have studied recently. His case was of particular interest since the iron...References1. HARTMANNJENKINSMCKEEHEYSSEL RCDECRM: Paroxysmal nocturnal hemoglobinuria: clinical and laboratory studies relating to iron metabolism and therapy with androgen and iron. Medicine (Balt.) 45: 331, 1966. CrossrefMedlineGoogle Scholar2. RAPAPORTREILLYEADECARNE SIEBNRHO: Paroxysmal nocturnal hemoglobinuria: case report with comments upon the urinary iron loss. Ann. Intern. Med. 44: 812, 1956. LinkGoogle Scholar3. MENGELKANNO'MALLEY CEHEBW: Increased hemolysis after intramuscular iron administration in patients with paroxysmal nocturnal hemoglobinuria. 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BINDERHERTINGHURSTFINCHSPIRO HJDCVSCHM: Tocopherol deficiency in man. New Eng. J. Med. 273: 1289, 1965. CrossrefMedlineGoogle Scholar10. NITOWSKYTILDON HMJT: Some studies of tocopherol deficiency in infants and children. III. Relation of blood catalase activity and other factors to hemolysis of erythrocytes in hydrogen peroxides. Amer. J. Clin. Nutr. 4: 397, 1956. CrossrefMedlineGoogle Scholar11. MARTINEK RG: Method for the determination of vitamin E (total tocopherols) in serum. Clin. Chem. 10: 1078, 1964. CrossrefMedlineGoogle Scholar12. FEINSTEIN RN: Perborate as substrate in a new assay of catalase. J. Biol. Chem. 180: 1197, 1949. CrossrefMedlineGoogle Scholar13. ZINKHAMLENHARDCHILDS WHREB: A deficiency of glucose-6-phosphate dehydrogenase activity in erythrocytes from patients with favism. Bull. Hopkins Hosp. 102: 169, 1958. MedlineGoogle Scholar14. HARTMANNJENKINS RCDE: Paroxysmal nocturnal hemoglobinuria: current concepts of certain pathophysiologic features. Blood 25: 850, 1965. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HERBERT E. KANNJR., M.D.; CHARLES E. MENGEL, M.D.; ROBERT L. WALL, M.D., F.A.C.P.Affiliations: Columbus, OhioFrom the Department of Medicine, The Ohio State University, Columbus, Ohio.This study was supported by research grants CA-08699 and CA-08702 and training grant CA-5192-01, U. S. Public Health Service, Washington, D. C.At the time of this study Dr. Kann was a Research Fellow and Dr. Mengel was a John and Mary R. Markle Scholar in Academic Medicine, The Ohio State University, Columbus, Ohio.Requests for reprints should be addressed to Charles E. Mengel, M.D., Director, Division of Hematology and Oncology, N-1031 University Hospital, Columbus, Ohio 43210. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byA Potential Rapid Screening Test for Paroxysmal Nocturnal HemoglobinuriaThe Differential Diagnosis of Hemolytic Anemias 1 September 1967Volume 67, Issue 3_Part_1Page: 593-596KeywordsAcademic medicineHemoglobinHemolytic anemiaIron deficiencyMedical servicesResearch grantsUrine ePublished: 1 December 2008 Issue Published: 1 September 1967 PDF downloadLoading ...