May 1983

Iron Deficiency and Sickle Cell Anemia

Author Affiliations

From the Division of Hematology (Drs Rao, Patel, and McGinnis), Cook County Hospital and Hektoen Institute for Medical Research and the Department of Pediatrics, Northwestern University and Childrens Memorial Hospital (Dr Honig and Ms Vida), Chicago.

Arch Intern Med. 1983;143(5):1030-1032. doi:10.1001/archinte.1983.00350050194038

• In a patient with sickle cell anemia, iron deficiency was accompanied by hypochromic, microcytic RBCs, absence of bone marrow iron, and a low serum ferritin level. The mean corpuscular hemoglobin concentration (MCHC) was decreased (27.6 g/dL) and was associated with an extreme scarcity of sickled erythrocytes in blood smears. Iron therapy resulted in reticulocytosis and an increase in sickled erythrocytes. In vitro studies demonstrated a decrease in sickling of erythrocytes as a function of oxygen saturation of the blood when the patient was iron deficient. The whole blood oxygen dissociation curve showed a substantial decrease in oxygen pressure necessary to produce 50% saturation of hemoglobin at pH 7.4 and 37 °C (P50), indicating an increased oxygen affinity. These data suggest that a reduction of the MCHC induced by iron deficiency may ameliorate sickling.

(Arch Intern Med 1983;143:1030-1032)