Vitamin E-dependent anemia in the premature infant. I. Effects of large doses of medicinal iron

Abstract

Description of a hemolytic anemia associated with vitamin E deficiency in premature infants prompted study of the relationships of medicinal iron, vitamin E, and hematologic parameters during the early life of such infants. A total of 186 patients categorized according to birth weight and gestational age were placed in study groups: (1) no iron or vitamin E supplement, (2) oral vitamin E supplement, (3) oral iron supplement, and (4) iron and vitamin E supplements. Significantly lower mean hemoglobin and serum vitamin E concentrations, with higher reticulocyte count and hydrogen peroxide fragility, were found during the second month of life in infants with a gestational age less than 36 weeks who were not receiving vitamin E. Hemoglobin values were lowest and reticulocyte counts highest in vitamin E-deficient infants of low gestational age who received supplemental iron. These observations suggest that therapeutic doses of iron increase red cell hemolysis during a period of vitamin E deficiency. Description of a hemolytic anemia associated with vitamin E deficiency in premature infants prompted study of the relationships of medicinal iron, vitamin E, and hematologic parameters during the early life of such infants. A total of 186 patients categorized according to birth weight and gestational age were placed in study groups: (1) no iron or vitamin E supplement, (2) oral vitamin E supplement, (3) oral iron supplement, and (4) iron and vitamin E supplements. Significantly lower mean hemoglobin and serum vitamin E concentrations, with higher reticulocyte count and hydrogen peroxide fragility, were found during the second month of life in infants with a gestational age less than 36 weeks who were not receiving vitamin E. Hemoglobin values were lowest and reticulocyte counts highest in vitamin E-deficient infants of low gestational age who received supplemental iron. These observations suggest that therapeutic doses of iron increase red cell hemolysis during a period of vitamin E deficiency.