The consequences of iron deficiency for the red blood cell are well established and widely appreciated. Far less clear are the implications of iron deficiency for organ systems and tissues other than the erythron. That deficiency may lead to complex malfunction is suggested by descriptions of widespread metabolic disturbances in at least some deficient subjects. Synthesis of heme-containing enzymes (the cytochromes, peroxidase, catalase) is impaired, and the function of those enzymes activated by iron may be jeopardized. The concentration of myoglobin in skeletal muscle is decreased. Bone marrow cells fail to synthesize DNA and globin at normal rates. Although the clinical consequences of these covert changes are incompletely defined, a number of features have been attributed to tissue lack of iron: flabby musculature, weakness, irritability, anorexia, pica, koilonychia and other epithelial changes, intestinal malfunction, and decreased attentiveness. In addition, there is the widespread impression among many seasoned pediatricians that
LUKENS JN. Iron Deficiency and Infection: Fact or Fable. Am J Dis Child. 1975;129(2):160–162. doi:10.1001/archpedi.1975.02120390004002
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