Hematologic evaluation of 164 patients with scleroderma showed frequency of anemia to be 29%. Anemia was usually observed during the more serious systemic stages or when complications such as severe malabsorption or renal disease were present. Marrow aplasia, associated with severe intestinal malabsorption of fat, iron, and vitamin B12, was observed in 6% of the anemic patients. Iron deficiency was considered the cause or contributed to the cause of anemia in 50% of the anemic patients. In two patients, iron deficiency was caused by decreased intestinal absorption of iron. The precise relationship of vitamin B12 deficiency to the anemia of these patients was not determined although malabsorption of B12 was regularly observed when severe malabsorption of other substances occurred. In one patient, abnormality in B12 absorption appeared to be the only absorptive defect.
Westerman MP, Martinez RC, Medsger TA, Totten RS, Rodnan GP. Anemia and Scleroderma: Frequency, Causes, and Marrow Findings. Arch Intern Med. 1968;122(1):39–42. doi:10.1001/archinte.1968.00300060041007
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