Clinical Disorders of Iron Utilization

Abstract

Inadequate hemoglobin production, characteristically associated with iron-deficiency anemia, may also occur in a variety of clinical disorders which manifest defective iron utilization rather than lack of iron. Defects may involve (1) plasma iron transport (deficiency of transferrin, anemia of infection), (2) intramedullary iron transport (chloramphenicol toxicity) or (3) hemoglobin synthesis (pyridoxine-responsive anemia, thalassemia, lead poisoning, hypochromic iron-loading anemia). Differentiation of true iron-deficiency anemia from defective iron utilization depends primarily on assessment of iron stores by determination of the level of serum iron and iron-binding protein, determination of stainable bone marrow iron, and occasionally a therapeutic trial of parenteral iron.