Publication: Increased red blood cell protoporphyrin in thalassemia: A result of relative iron deficiency
Issued Date
1984-01-01
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ISSN
00029173
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2-s2.0-0021171846
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Mahidol University
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SCOPUS
Bibliographic Citation
American Journal of Clinical Pathology. Vol.82, No.3 (1984), 289-293
Suggested Citation
P. Pootrakul, J. Wattanasaree, M. Anuwatanakulchai, P. Wasi Increased red blood cell protoporphyrin in thalassemia: A result of relative iron deficiency. American Journal of Clinical Pathology. Vol.82, No.3 (1984), 289-293. doi:10.1093/ajcp/82.3.289 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/30696
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Title
Increased red blood cell protoporphyrin in thalassemia: A result of relative iron deficiency
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Abstract
Erythrocyte protoporphyrin (EP) was measured in 50 normal control subjects, 22 iron-responsive anemic subjects, and in 106 patients with thalassemic diseases. All normal subjects had EP of less than 80 μg/dL red blood cells, whereas all iron-deficiency subjects had EP of more than 80 μg/dL red blood cells. Six of 22 heterozygotes for thalassemias had elevated EP, and all of these had transferrin iron saturation of less than 16%, reflecting a complicating iron deficiency. Among 52 patients with β-thalassemia/hemoglobin (Hb) E disease, 26.9% had elevated EP levels, and among 32 patients with Hb H disease, 40.6% had elevated EP. These elevated EP levels were associated with transferrin iron saturation between 18 and 44%. In none of the thalassemic patients with transferrin iron saturation above 44% was EP elevated. These findings suggest that elevation of EP in some thalassemic patients causally is related to iron supply inadequate for the massively expanded erythropoiesis. This relative iron deficiency in thalassemia occurs at a transferrin iron saturation level usually considered to be normal. These relationships demonstrate the need for an increased iron supply in patients with erythroid marrow hyperplasia, if erythropoiesis is to proceed at maximal rates.