Application of Radioisotopes in the Study of Hookworm Infection in Thailand

Abstract

Anaemia caused by hookworm is common in Thailand and it is known that such anaemia is due to iron deficiency resulting from intestinal blood loss. In the present experiments, blood loss, iron absorption, iron reabsorption and serum albumin loss were studied using radioactive 51 Cr and 59 Fe in 15 patients with hookworm anaemia. Blood loss per worm per day was found to be 0–097 ml (range 0–023‐0‐260) and it was inversely proportional to the total amount of hookworms. About 64% (range 41–83%) of the iron loss caused by hookworm was reabsorbed in the intestine in 6 patients studied. There was a linear relationship between iron reabsorbed and iron loss, and the state of iron deficiency. An average of 89% of iron given orally was found to be absorbed in 9 hookworms patients with severe anaemia. 51 Cr‐labelled human serum albumin was used to study the loss of plasma protein in 15 hookworm patients. The results showed that they lost albumin equivalent to that in 21 to 128 ml of plasma per day or 0–06 to 2–74% of the intravenously administered. 51 Cr‐albumin appeared in the subsequent 4 days faecal collection from patients harbouring 1,200 to 20,000 hookworm egg/gm faeces. There was a direct relationship between the number of egg/gm of faeces and the faecal 51 Cr‐albumin excretion and an inverse correlation between the serum albumin concentration and the amount of 51 Cr‐albumin measured in the stool. The urinary excretion test for 58 Co‐labelled vitamin B 12 and 3 H‐labelled folic acid were also performed in 27 hookworm patients. Five out of 21 and 6 out of 13 cases showed possibly impaired absorption of vitamin B 12 and folic acid respectively. The serum vitamin B 12 concentration in 27 hookworm patients were also lower than in normal subjects. All these findings showed no relationship to the degree of anaemia or the number of worms recovered from the hookworm patients. Copyright © 1972, Wiley Blackwell. All rights reserved