Serum copper, iron and iron binding capacity in kwashiorkor

Hypomagnesaemia and muscle electrolytes and metabolites

Ten patients, aged 39-61 years, with hypomagnesaemia due to chronic alcoholism (7 cases) or malabsorption (3 cases), have been investigated by assessing the maximum isometric voluntary contraction force (MVC) of the quadriceps femoris muscle (7 cases), laboratory screening (9 cases) and estimating the electrolyte and metabolite content of biopsy specimens from the quadriceps femoris muscle. The MVC ranged from 0.5 to 34 kp and was significantly lower than in 12 apparently healthy normomagnesaemic controls (p is less than 0.001). The results of the laboratory screening, apart from a significant lowering of the serum magnesium concentration (p is less than 0.01), were mainly within the range of normal values, apart from signs of liver damage, such as an elevated activity of S-OCT (3 cases), alkaline phosphatease(3 cases), S-ALAT (1 case) and an elevation of bilirubin and blood ammonia (2 cases). Low serum iron-binding capacity occurred in 4 cases, a finding reported in protein-calorie malnutrition. Muscle magnesium content was significantly lower than in healthy controls (p is less than 0.001). Muslce sodium and chloride contents were significantly increased (p is less than 0.05). Total H2O content and the extracellular H2O content were both significantly increased (p is less than 0.05). Pyruvate and lactate values were within the normal range. The apparent equilibrium constant for creatine kinase differed significantly ( is less than 0.01). ATP values were within the normal range, but there were slight decreases for ADP (p is less than 0.05) and creatine phosphate ( is less than 0.01), whcih is of interest in view of the lowering of the MVC and the diminished capacity for sustained muscular effort in hypomagnesaemic patients reported earlier.

Strain variation in 59Fe absorption during aflatoxicosis

Strain variation of iron absorption in response to dietary aflatoxin was studied using two commercial broiler strains and a nonselected randombred strain. Aflatoxin depressed chick body weights and increased mortalities in each strain. Hematocrits were significantly reduced in the commercial broilers receiving the toxin, but not in the randombreds. Aflatoxin reduced iron absorption in each strain regardless of the presence of anemia.

The role of mucosal iron binding proteins in adaptation of iron absorption during protein deficiency and rehabilitation

1. A state of protein deficiency has been produced in rats by feeding a low protein diet, thereafter a period of rehabilitation with a normal protein but a low iron supply followed. 2. For characterization of the iron metabolism during both periods haemoglobin, total iron binding capacity, liver non-haemin iron, intestinal iron absorption and the uptake of 59Fe in the liver was determined. 3. Under these conditions the amount of 59Fe incorporated into the mucosal transferrin and the ferritin fractions has been measured. Both fractions were obtained from the supernatant of a mucosal homogenate after chromatography on sepharose 6B. 4. In anemia due to protein deficiency the typical increase of 59Fe incorporation into the fraction of mucosal transferrin--usually occuring in iron deficiency--could not be observed. This coincides with the absence of an increased iron absorption. Moreover a decrease of iron absorption is observed, which is associated with a decreased 59Fe ratio of transferrin/ferritin-fraction. 5. After normalization of the protein supply the ratio of 59Fe incorporated into the mucosal transferrin and ferritin fractions was changed remarkably in favor to transferrin together with a several fold increase of the intestinal iron absorption. 6. The conclusion is drawn that mucosal transferrin and ferritin enable the body not only to adapt the absorption to a higher but also to a lower requirement as it is the case in protein deficiency.

Immunity, transferrin, and survival in kwashiorkor

In a study of 40 children with kwashiorkor, serum albumin, transferrin, and immunoglobulin levels were measured. Treatment included chloroquine, pyrimethamine, multivitamins, folic acid, iron compounds, and a high-protein diet. After two weeks the mean serum transferrin values in the children who survived and those who died were 1.30 mg./ml. and 0.33 mg./ml., respectively. Many of the children died immediately after treatment started, and it is suggested that in children with severe kwashiorkor and low serum transferrin levels any increase in free-circulating iron may result in overwhelming infection and death. Thus the appropriate time for instituting iron therapy in such patients should be reconsidered.