BONE-MARROW AND CHELATABLE IRON IN PATIENTS WITH PROTEIN-ENERGY MALNUTRITION

Objectives. To examine the iron status of malnourished children by com paring bone marrow iron deposits in children with protein energy malnu trition with those in well-nourished controls, and measuring chelatabl e urinary iron excretion in children with kwashiorkor, Design. Bone ma rrow iron was assessed histologically in postmortem specimens from chi ldren with kwashiorkor or marasmus, and from controls, Twenty-four-hou r urinary iron was measured in children with severe kwashiorkor, half of whom received 10 mg/kg of intramuscular desferrioxamine (DFO) on ad mission, Setting. Red Cross War Memorial Children's Hospital, Cape Tow n, Subjects. Thirteen children with kwashiorkor, 6 with marasmus and 1 6 well-nourished children underwent bone marrow examination, Urinary i ron excretion was assayed in 17 children with kwashiorkor. Results. St ainable iron was present in the bone marrow of half the children with kwashiorkor but in only 1 child in each of the other groups, The media n iron excretion was 945.5 mu g/24 hours in the DFO group compared wit h 28.5 mu g/24 hours in the non-DFO group, Conclusions. There is an ap parent excess of iron which may predispose to bacterial infections and free radical-mediated injury in children with kwashiorkor.