Iron metabolism in Egyptian infants with protein -calorie deficiency

I . Studies were made of iron absorption in eighty-five infants who were suffering from protein-calorie deficiency (kwashiorkor and marasmus) and in eight infants who were suffering from Fe-deficiency anaemia : twenty-one healthy infants were used as control subjects. Factors affecting absorption concentration of serum total protein and its fractions; serum Fe; transferrin (as indicated by total Fe-binding capacity) and its percentage saturation; blood haemoglobin; total blood Fe; and the state of Fe stores in the liver were also investigated. Four of the infants who were suffering from severe kwashiorkor were selected for a follow-up study and were given a high-protein diet and blood transfusions. 2. Alimentary Fe absorption was retarded in infants with protein-calorie deficiency. Total serum proteins and its fractions were reduced. Blood haemoglobin, total blood Fe, serum Fe and total Fc-binding capacity were also decreased but the percentage of transferring saturation was increased. Liver proteins per g wet weight of liver were decreased, whereas liver non-haem Fe was increased. The extent of these changes varied according to the clinical condition. 3. In infants with Fe-deficiency anaemia there was no change in liver protein concentrations or total serum proteins, except for a slight increase in the P-globulin fraction of the latter. Blood haemoglobin and total Fe were reduced, whereas serum total Fe-binding capacity was raised and the percentage of transferrin saturation was lowered. A fall in the liver non-hacm Fe concentration was observed. 4. After giving a high-protein diet to infants with severe kwashiorkor, the characteristic anaemia associated with protein-calorie deficiency changed and the general manifestations of Fe-deficiency anaemia emerged. After blood transfusion, these infants showed a marked clinical improvement.