Urinary iron in patients with sickle cell anamia

Urinary iron excretion was measured in patients with sickle cell anemia and relateddiseases. Iron concentration in urine was determined by atomic absorption spectrophotometry and daily total iron excretion was calculated from this and total daily urine volume. Normal subjects excreted a mean of 88 pg Fe per day (95 per cent confidence limitsof 0 to 120 pg). Nine persons with sickle cell trait had normal Fe excretion rates.However, abnormally high iron excretion was present in the first urine sample obtainedfrom 27/31 patients with SS, 3/7 with SC, 1/2 with CC, and 1 with S-thalassemia. Iron excretion varied very significantly from day-to-day in individual patients. The results of studies attemting to relate this to increase excretion during activityas compared to rest were negative. No clear relationship of iron excretion to painfulcrisis could be shown, but remarkable rises in urine iron occurred in two patients who developed a hyperhemolytic crisis. These studies suggest that urinary iron reflects intravascular hemolysis primarily. No correlation was evident between urine iron and the patients' age, transfusion history, or serum iron values suggesting increased urinary iron excretion cannot be attributed to iron overload in sickle cell anemia.

[March hemoglobinuria. One case with erythrocyte glutathione peroxidase deficiency]

A new case of march haemoglobinuria seen in a 21-year-old man is reported. A deficiency in two erythrocytic enzymes (glutathione reductase and glutathione peroxydase) was observed. Treatment with riboflavin corrected the glutathione reductase deficiency. The march haemoglobinuria and glutathione peroxydase deficiency persisted. Several months after resolution of the march haemoglobinuria, a new estimation of glutathione peroxydase showed that the deficiency had disappeared. The possible role of a transient deficiency in erythrocyte glutathione peroxydase in the pathogenesis of march haemoglobinuria is discussed.

Acute renal insufficiency in the rabbit by glycerol

The appearance of an acute renal insufficiency in the rabbit, after glycerol injection (10, 13 or 15 ml/kg of a 50% solution) is investigated. After a 24 hours of intoxication, especially in the ten following days, cylinders, erythrocytes and renal cells appear in the urine sediment. Proteinuria appears after 24 hours and practically disappears after 72 h. Glucosuria persists from 24 hours to 6 days. Haemoglobinuria is intense after 24 and 48 hours and persists slightly about 6 days. Na, K and Cl elimination in urine diminishes clearly in all animals. Plasma K increases in non-surviving animals and does not change in those surviving. Plasma Na does not change in the dying ones, and decreases in those surviving. In non-surviving animals, pH, pCO2 and CO3H minus decrease sharply. In the surviving ones pCO2 decreases clearly after 24 hours, increasing afterwards slowly to normal values. pH increases, slightly during the first 48 hours, and then neatly during approximately 6 days. Standard CO2H minus does not change during the first 48 hours, increasing afterwards during 6 to 7 days. Histologically, the chief lesion is a vacuolar degeneration of the proximal tubule. The possible mechanisms of such alterations are discussed.

Acute anaphylaxis, pulmonary oedema, and intravascular haemolysis due to cryoprecipitate

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