PLASMA-FREE IRON - A POSSIBLE CAUSE OF EDEMA IN KWASHIORKOR

Background-Oedema is a sine qua non for the diagnosis of kwashiorkor y et the mechanisms leading to oedema remain ill defined. Aims-To relate the plasma concentration of radical promoting 'free' iron to the degr ee of oedema in patients with kwashiorkor. Setting-University teaching hospital. Patients-Fifteen children with kwashiorkor, nine of whom ha d severe and six of whom had a moderate degree of oedema. Methods-Plas ma 'free' iron was measured as bleomycin detectable iron (BDI) and rel ated to severity of oedema and plasma albumin concentration. Results-B DI was significantly higher in the patients with severe oedema (20.5 v 6.75 mu mol/l) whereas the albumin concentrations were similar (16 v 17 g/l). BDI was no longer present in any patients 30 days after admis sion. Conclusions-'Free' circulating iron may contribute to the oedema of kwashiorkor, and its sequestration could hasten recovery and decre ase morbidity and mortality.