Evaluation of the Anemia of Rheumatoid Arthritis

Thirty-six patients with active rheumatoid arthritis in whom anemia wasslight were investigated, in part with radioiron and radiochromium, for abnormalities which might lead to anemia.

The primary defect appeared to be a pronounced reduction of abilityto absorb iron from the intestinal tract. There was an equally marked reduction in the serum concentration of iron which could not be attributedto the slight reduction in the iron-binding capacity of the serum. Despitethe reduction level of iron in the serum, the apparent turnover of iron wasso rapid that the total clearance per day was normal or moderately elevated.However, the fraction of the iron cleared from the blood and appearing inthe circulation in newly synthesized erythrocytes was slighfly depressed.Erythrocyte survival was normal or very slightly shortened; hemolysis seemsto play no important role. The fecal excretion of radioiron, not associatedwith erythrocytes, was greatly increased in two patients in whom there wasno evidence of intestinal bleeding. A moderate increase in plasma vohime wascommon.

Submitted on August 3, 1962 Accepted on November 3, 1962