Increased Hemolysis after Intramuscular Iron Administration in Patients with Paroxysmal Nocturnal Hemoglobinuria: Report of Six Occurrences in Four Patients, and Speculations on a Possible Mechanism

Four patients with PNH were described who developed accelerated activityof their disease after the intramuscular administration of iron-dextran fortreatment of iron deficiency. This was considered to reflect a unique effect ofiron on PNH erythrocytes. It was postulated that this effect resulted from celldamage caused by iron catalyzed peroxidation of erythrocyte lipids, a reaction to which PNH erythrocytes could be unusually susceptible by virtue ofan increased content of unsaturated fatty acids or pro-oxidants or decreasedcontent of antioxidants.

Submitted on August 13, 1964 Accepted on November 11, 1964