Erythropoiesis in the anaemia of rheumatoid arthritis

Abstract

Erythropoietic activity and mean red-cell lifespan were measured using 59Fe-transferrin in 32 anemic patients with active rheumatoid arthritis (RA) and in 20 hematologically normal subjects. Marrow Fe turnover (MIT) in the patients was normal and in only 11 was red-cell lifespan less than 70 days. Ineffective Fe turnover (IIT) was significantly increased in those patients in whom there was evidence of Fe deficiency (serum ferritin less than 12 .mu.g/l) but in the remaining patients IIT was significantly less than in the normal subjects. In a further 19 patients with simple Fe deficiency anemia IIT was significantly increased. The marrow response to chronic inflammatory disease is clearly distinct from that seen in simple Fe deficiency and this suggests different pathogenic mechanisms for these 2 anemias.