Studies on iron metabolism: I. Evidence of gastrointestinal dysfunction in infants withiron deficiency anemia: A preliminary report

Abstract

<h2>Summary</h2> A preliminary study of a group of infantswith iron deficiency anemia has revealed evidence of occult gastrointestinal bleeding, precipitins to cow's milk, and the passage of serum proteins into gastric juice. These findings are strong evidence of gastrointestinal dysfunction. Guaiac-positive stools were found in 40per cent of the iron-deficient infants tested. Precipitins to cow's milk were found in 75 to 80 per cent of the iron-deficient subjects who were taking this food prior to diagnosis. This is regarded as an abnormal finding. Serum proteins in the fasting gastric juice were demonstrated in 12/13 of anemic subjects and in 2/12 of control subjects by means of agar diffusion techniques. Semiquantitative estimates of serum albumin, and gamma globulin in the gastric juice suggest a pathologic loss of these proteins in at least some anemic subjects. These findings suggest the existence of at least 2 forms of iron deficiency anemia in infants; two forms, that is, which are etiologically distinct. The first of these has been termed "primary iron deficiency"; the second is believed to depend on primary sensitization to cow's milk. Mechanisms have been proposed to explain the possible interrelationships of the causative factors in each group.