Blue Sclerae and Iron Deficiency

Abstract

Sir .—Osler 1 described the association of blue sclerae and iron deficiency anemia in teenaged girls. That finding received apparent further support from Kalra et al 2 in a study of adult inpatients. We sought to validate this association in infants and young children. Thirty-four patients, ages 4 months to 5 years, 25 of whom were black and nine white, were examined by a pediatric house officer and attending physician. Anemia was defined as a hemoglobin value less than 105 g/L in children less than 2 years of age and less than 115 g/L in those over 2 years of age. The diagnosis of iron deficiency was confirmed by a free erythrocyte protoporphyrin value greater than 350 g/L of whole blood. Five of the 34 study patients had blue sclerae and only two of these five were anemic. Thus three patients with blue sclerae had no laboratory evidence of