Combined deficiencies of iron and folic acid are common occurrences especially in
pregnancy and in the post-gastrectomy state.
Although it is well known that iron deficiency may mask the morphological
abnormalities of coexisting folic acid or vitamin B12 deficiency, it is less
widely appreciated that iron deficiency is frequently associated with decreased serum
folic acid levels and may predispose patients to folic acid deficiency. It is not completely
settled down that deficiency status may be due to an additional demand for folate or an
abnormality of folate matabolism produced by the iron deficiency.
In order to observe the change following iron deficiency and the effect of iron on
folate metabolism, we conducted the following studies in 10 patients with iron deficiency
anemia with 30 healthy persons as the control; Hemoglobin, hematocrit, serum iron,
serum and red cell folate, serum vitamin B12 level, and morphological
studies of peripheral blood and bone marrow.
The following results were obtained:
1. In patients with iron deficiency anemia, the serum folate level was 5.8±0.6ng/㎖
which was lower than control value, while red cell folate level was 333.8±42.4ng/㎖ and
showed statiscally significant increase, compared with normal value of 234.5±17.8ng/㎖
(p<0.05).
2. The mean neutrophil lobe count in the anemic group was 3.31±0.06 which was
significantly higher than 2.99±0.04 in the control and tend to be increased especially
when serum iron level decreased.
3. The red cell folate level seemed to be increased and serum folate level decreased as
serum iron decreased.
4. The change following the correction of iron deficiency in these patients suggested
that iron therapy produced a fall in the red cell folate level and diminution of neutrophil
lobe count with concomitant increase of serum folate level.
With the above results, it is concluded that iron deficiency may impair the metabolism
of folic acid rather than producing secondary folic acid deficiency.
|