Abstract
To elucidate the mechanism of anemia in rheumatoid arthritis (RA), iron-related parameters were examined in 26 RA patients, and ferrokinetic and erythrokinetic studies were performed on 9 and 8 of the 26 cases, respectively. As a whole, mild or moderate hypochromic normocytic anemia was observed. Serum iron levels were markedly decreased and the percent transferrin iron saturation was decreased or normal, while the serum concentration of ferritin fell within the normal range in all but one of the cases examined. Ferrokinetic studies revealed a decreased red cell iron turnover rate in 4 out of 9 cases and reduced red cell iron utilization in 2 out of 9 cases. Erythrokinetic studies disclosed that red cell life span was shortened in 5 cases and that total red cell volume was decreased in all 8 cases examined. Hemoglobin production per day was reduced in all 8 cases. In addition, the activity of δ-aminolevulinic acid synthetase was decreased in 2 cases examined. These findings suggest that abnormal iron metabolism and heme synthesis may be involved as causes of the anemia complicating RA.
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