Dr Steinberg takes issue with several statements in the article entitled "Sickle Cell Anemia and Iron Deficiency: Resemblance to Sickle Thalassemia."First, he has made several calculations that may be incorrect for an individual with iron deficiency, as reported by Dagg et al.1 It is conceivable that this patient lost varying amounts of iron in the urine daily, as his iron stores became depleted.Dr Steinberg also said that it is likely another source of blood loss was present. The patient has since died, and at postmortem, a careful study failed (1) to obtain stainable iron in any organ or (2) to find any pathological lesion to account for the blood loss.The patient had a persistent reticulocytosis, absent serum haptoglobin, and increased plasma hemoglobin levels. Therefore, there was intravascular hemolysis. Dr Steinberg also says that we have pointed out that there was no GU tract blood
Natta C. Sickle Cell Anemia and Iron Deficiency-Reply. JAMA. 1982;248(17):2112–2113. doi:10.1001/jama.1982.03330170020009
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