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Apparent Folate Deficiency in Iron‐Deficiency Anaemia
Author(s) -
Roberts P. D.,
StJohn D. J. B.,
Sinha R.,
Stewart J. S.,
Baird I. M.,
Coghill N. F.,
Morgan J. O.
Publication year - 1971
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1971.tb07025.x
Subject(s) - iron deficiency , medicine , bone marrow , red cell , excretion , serum iron , endocrinology , vitamin , anemia , gastroenterology , immunology
S ummary . Examination of 50 patients with iron‐deficient hypochromic anaemia showed evidence suggesting a high incidence of folate depletion. The peripheral blood films of 44 patients (88%) showed more than 3% of neutrophils with five nuclear lobes, 35 patients (70%) had a high mean neutrophil lobe count, 20 patients (40%) had hypersegmented neutrophils and 19 patients (38%) had giant metamyelocytes in the bone marrow. The serum folate was below 3 ng/ml in 12 patients and 3–6 ng/ml in 18. Red‐cell folate was subnormal in 15%, and 45% had a positive Figlu test. Correlation between various tests for folate deficiency was not found, apart from a correlation between red‐cell folate levels and morphological changes in the neutrophils. The haemoglobin rise following intravenous iron therapy was smaller when the serum folate level was low. There was probably a similar relationship to the red‐cell folate level, but the numbers tested were small. The presence of neutrophil multilobing in the peripheral blood film and giant metamyelocytes in the bone marrow did not influence the response to iron therapy, neither did an abnormal Figlu excretion. Following intravenous iron therapy, both neutrophil multilobing and marrow giant metamyelocytes were significantly reduced in number. This therapy did not significantly alter Figlu excretion measured 6 weeks after treatment, but both serum and red‐cell folate levels fell. Intravenous iron therapy did not produce any significant changes in the serum vitamin B 12 levels. The part that iron deficiency itself may play in causing apparent folate depletion is discussed.