Bone marrow and chelatable iron in patients with protein energy malnutrition

  • AA Sive
  • WS Dempster
  • S Rosseau
  • M Kelly
  • H Malan
  • H de V. Heese

Abstract

Objectives: To examine the iron status of malnourished children by comparing bone marrow iron deposits in children with protein energy malnutrition with those in well-nourished controls, and measuring chelatable urinary iron excretion in children with kwashiorkor. Design: Bone marrow iron was assessed histologicaHy in postmortem specimens from children with kwashiorkor or marasmus, and from controls. Twenty-four-hour urinary iron was measured in children with severe kwashiorkor, half of whom received 10 mg/kg of intramuscular desferrioxamine (DFO) on admission.  Setting: Red Cross War Memorial Children's Hospital, Cape Town. Subjects: Thirteen children with kwashiorkor, 6 with marasmus and 16 well-nourished children underwent bone marrow examination. Urinary iron excretion was assayed in 17 children with kwashiorkor. Results: Stainable iron was present in the bone marrow of half the children with kwashiorkor but in only 1 child in each of the other groups. The median iron excretion was 945.5 µg/24 hours in the DFO group compared with 28.5 µg/24 hours in the non-DFO group. Conclusions: There is an apparent excess of iron which may predispose to bacterial infections and free radicalmediated injury in children with kwashiorkor. 

S AFr Med J 1996; 86: 1410-1413

Author Biographies

AA Sive
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
WS Dempster
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
S Rosseau
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
M Kelly
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
H Malan
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
H de V. Heese
Departments of Paediatrics and Child Health and Pathology, Red Cross War Memorial Children's Hospital and University of Cape Town
Published
2017-06-08
Section
Articles

Journal Identifiers


eISSN: 0256-95749
print ISSN: 2078-5135