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Nutritional Iron Deficiency Anemia in an Adult Male
Report of a Case
- ERNEST ROSENBAUM, M.D.; and
- JOSEPH W. LEONARD, M.D.
- Requests for reprints should be addressed to Joseph W. Leonard, M.D., Department of Hypertension and Renal Disease, Cleveland Clinic, 2020 East 93rd Street, Cleveland 6, Ohio.
Excerpt
Hypochromic microcytic anemia is probably the most common type of anemia and in adults is almost always the result of pathologic blood loss. In 1955, Moore (1) stated that in the United States there was not a single, well-documented published instance in which iron deficiency anemia has been shown to develop in an adult male in the absence of blood loss. By estimating total body iron and calculating the amount of iron lost from the body, Moore (2) concluded that it would require 10 years or more for an adult male to develop iron-deficiency anemia on a purely nutritional basis.
Acknowledgment
The authors acknowledge with gratitude the help and cooperation of Lee Block, M.D., Medical Consultant, Napa State Hospital, Imola, California; William F. Luttgens, M.D., formerly Consultant in Hematology, San Francisco General Hospital and Stanford University School of Medicine, San Francisco, California; and William W. Thayer, M.D., formerly Fellow in Hematology, San Francisco General Hospital, University of California School of Medicine, San Francisco, California.
Also to: Mario Baldini, M.D. and W. J. Mitus, M.D. of the Blood Research Laboratory, Pratt Clinic-New England Center Hospital and Tufts University School of Medicine, Boston, Massachusetts, for their assistance in preparing this manuscript.
Summario in Interlingua
Plure autores ha asserite que anemia a carentia de ferro in masculos adulte es quasi assecuratemente le resultato de un perdita pathologic de sanguine. Le presente reporto contribue un caso de anemia a carentia de ferro nutritional.
Post un episodio psychotic, le patiente—un masculo de 58 annos de etate al tempore hic reportate—habeva mantenite un dieta con approximativemente 2,3 a 3 mg de ferro per die durante 27 annos. Ille esseva hospitalisate post un episodio de syncope e pneumonitis. Le examine physic revelava un homine pallide, con lingua lisie, aspere murmures de ejection precordial systolic, hepate e splen a duo, respectivemente un largor de digito infra lor margines costal, e ungulas profundemente cochleate e crestate. Le hemoglobina amontava al tempore del admission a 4 g, con microcytosis, hypochromia, poikocytosis, e anisocytosis. Le medulla ossee monstrava micre normoblastos con magre quantitates de cytoplasma basophilic e un margine cellular irregular. Le ferro del sero esseva 14 microgrammas per 100 ml. Le directe test de Coombs esseva negative. Le patiente esseva tractate con 3.500 mg de dextrano a ferro (Imferon) in doses dividite. Le septime die, le numeration del reticulocytos esseva 8 pro cento, e intra tres septimanas le hemoglobina habeva montate a 9 g. Post tres menses, le hemoglobina esseva 13 g. Cinque annos plus tarde illo esseva 13,8 g.
Esseva calculate que approximativemente 11 annos esseva requirite pro descender a 4 g de hemoglobina sub le conditiones del dieta describite. Chronic perdita de sanguine esseva excludite in tanto que possibile, e nulle evidentia de malabsorption esseva trovate. Le prompte responsa al therapia a ferro demonstrava que le anemia esseva causate per un specific carentia de ferro. Cinque annos post le hospitalisation, le patiente se trovava in bon stato de sanitate. Isto elimina le possibilitate de un occulte malignitate.
Article and Author Information
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From San Francisco General Hospital, San Francisco, California.
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- Received January 8, 1963.
- Accepted January 15, 1964.
