Serum Erythrocyte Folate Levels in Thalassaemic Patients in Thailand

Abstract

The mean serum and adjusted red cell folate levels, as measured by microassay using Lactobacillus casei, respectively were 8.87 ± SD 3.28 μg/1 and 436 ± SD 107 μg/1 in 76 normal subjects, 4.22 ± SD 2.70 μg/1 and 182 ± SD 114 μg/1 in 55 patients with β‐thalassaemia/Hb E disease and 6.36 + SD 2.95 μg/1 and 320 ± 158 μg/1 in 37 patients with Hb H disease. The mean serum and adjusted red cell folate values of the patients with β‐thalassaemia/Hb E disease and the mean serum folate value of the patients with Hb H disease were significantly lower than those of the normal subjects (P < 0.001). 33 % of the β‐thalassaemia/Hb E patients and 8 % of the Hb H patients showed low serum folate levels ( < 3 μg/1) whereas 84 % of the former and 45 % of the latter showed low adjusted red cell folate levels ( < 270 μg/1). The group of β‐thalassaemia/Hb E disease with low serum folate levels had lower mean haemoglobin concentration and lower mean adjusted red cell folate level than the group with normal serum folate levels. Since the Thai diets have high folate content, the observed low serum and erythrocyte folate levels in thalassaemic patients most likely occur from massively increased erythropoiesis. Folate, 5 mg/d, is now routinely prescribed to such patients especially to those with severe anaemia. © Munksgaard 1979