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November 1990

Blue Sclerae and Iron Deficiency

Author Affiliations

Department of Pediatrics St Louis University School of Medicine St Louis, MO 63104

Am J Dis Child. 1990;144(11):1180-1181. doi:10.1001/archpedi.1990.02150350010006

Sir.—Osler1 described the association of blue sclerae and iron deficiency anemia in teenaged girls. That finding received apparent further support from Kalra et al2 in a study of adult inpatients. We sought to validate this association in infants and young children. Thirty-four patients, ages 4 months to 5 years, 25 of whom were black and nine white, were examined by a pediatric house officer and attending physician. Anemia was defined as a hemoglobin value less than 105 g/L in children less than 2 years of age and less than 115 g/L in those over 2 years of age. The diagnosis of iron deficiency was confirmed by a free erythrocyte protoporphyrin value greater than 350 g/L of whole blood. Five of the 34 study patients had blue sclerae and only two of these five were anemic. Thus three patients with blue sclerae had no laboratory evidence of

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