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June 29, 1957


JAMA. 1957;164(9):962-966. doi:10.1001/jama.1957.02980090016005

• Iron deficiency in 24 infants was treated by intramuscular injection of solutions of an iron-dextran complex. The dosage was at the rate of 50 to 100 mg. of elemental iron per day, and the total iron given ranged from 100 mg. (for infants under 6 months of age) to 400 mg. (for those over 24 months). Twelve of the children were classed as severely anemic and 12 as moderately anemic, according to whether the hemoglobin level was below or above 7.5 Gm. per 100 ml. The characteristic picture of severe iron-deficiency anemia included red blood cell counts not lower than 2,400,000 per cubic millimeter, mean corpuscular volume from 72 to 48 cu. μ, and mean corpuscular hemoglobin concentration from 30 to 22%. Within 48 hours after therapy, the newly formed red blood cells were recognizable in the blood smears, being distinguished by their rich color and large size from the pale, small cells surviving from the pretreatment period. Fifty per cent of the small cells disappeared from the circulation in about 35 days. Reticulocyte counts reached maximum values about the fifth day of treatment, and the hemoglobin level generally reached 11 Gm. per 100 ml. in three weeks. There were no untoward effects from these iron injections, but it is emphasized that failure of a patient to respond to these doses is never an indication for giving more iron; if hemoglobin values do not rise at least 2 Gm. in three weeks, other possible causes of anemia should be considered.