A comparison between concentrations of free erythrocyte protoporphyrin and serum ferritin during development of iron deficiency by phlebotomy in polycythaemia vera patients. 1987

G Birgegård, and C H de Verdier, and C Högman
Department of Internal Medicine, University Hospital, Uppsala, Sweden.

Therapeutic venesection for polycythaemia vera (PV) produces iron deficiency. If iron supplementation is avoided, the frequency of venesections can be kept lower than if iron is given. This is the standard treatment for PV in our department, and this model for iron deficiency was used to compare serum ferritin, free erythrocyte protoporphyrin (FEP), serum iron and transferrin as indicators of iron deficiency. Eleven patients with PV were studied on a total of 90 occasions. Five patients were followed from normal iron status to iron deficiency, the other six were iron deficient at the start of the study. Serum ferritin and FEP became abnormal approximately simultaneously during the development of iron deficiency, serum ferritin in all patients, FEP in 8 out of 11 patients. There was a correlation between the two in all specimens (r = 0.75, p less than 0.001), but serum ferritin showed fewer false negative results. Serum transferrin alone was elevated only in 25% of the patients, and serum iron, although mostly subnormal, was rather inconsistent. It is concluded that serum ferritin and FEP can both be used to diagnose iron deficiency during venesection treatment of PV, whereas serum iron and transferrin are of little value.

UI MeSH Term Description Entries
D011087 Polycythemia Vera A myeloproliferative disorder of unknown etiology, characterized by abnormal proliferation of all hematopoietic bone marrow elements and an absolute increase in red cell mass and total blood volume, associated frequently with splenomegaly, leukocytosis, and thrombocythemia. Hematopoiesis is also reactive in extramedullary sites (liver and spleen). In time myelofibrosis occurs. Erythremia,Osler-Vaquez Disease,Polycythemia Rubra Vera,Polycythemia Ruba Vera,Primary Polycythemia,Disease, Osler-Vaquez,Erythremias,Osler Vaquez Disease,Polycythemia Ruba Veras,Polycythemia Rubra Veras,Polycythemia, Primary,Polycythemias, Primary,Primary Polycythemias,Ruba Vera, Polycythemia,Ruba Veras, Polycythemia,Vera, Polycythemia Ruba,Vera, Polycythemia Rubra,Veras, Polycythemia Ruba,Veras, Polycythemia Rubra
D011166 Porphyrins A group of compounds containing the porphin structure, four pyrrole rings connected by methine bridges in a cyclic configuration to which a variety of side chains are attached. The nature of the side chain is indicated by a prefix, as uroporphyrin, hematoporphyrin, etc. The porphyrins, in combination with iron, form the heme component in biologically significant compounds such as hemoglobin and myoglobin. Porphyrin
D011524 Protoporphyrins Porphyrins with four methyl, two vinyl, and two propionic acid side chains attached to the pyrrole rings. Protoporphyrin IX occurs in hemoglobin, myoglobin, and most of the cytochromes.
D001815 Bloodletting Puncture of a vein to draw blood for therapeutic purposes. Bloodletting therapy has been used in Talmudic and Indian medicine since the medieval time, and was still practiced widely in the 18th and 19th centuries. Its modern counterpart is PHLEBOTOMY.
D004912 Erythrocytes Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing HEMOGLOBIN whose function is to transport OXYGEN. Blood Cells, Red,Blood Corpuscles, Red,Red Blood Cells,Red Blood Corpuscles,Blood Cell, Red,Blood Corpuscle, Red,Erythrocyte,Red Blood Cell,Red Blood Corpuscle
D005293 Ferritins Iron-containing proteins that are widely distributed in animals, plants, and microorganisms. Their major function is to store IRON in a nontoxic bioavailable form. Each ferritin molecule consists of ferric iron in a hollow protein shell (APOFERRITINS) made of 24 subunits of various sequences depending on the species and tissue types. Basic Isoferritin,Ferritin,Isoferritin,Isoferritin, Basic
D006400 Hematocrit The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value. Erythrocyte Volume, Packed,Packed Red-Cell Volume,Erythrocyte Volumes, Packed,Hematocrits,Packed Erythrocyte Volume,Packed Erythrocyte Volumes,Packed Red Cell Volume,Packed Red-Cell Volumes,Red-Cell Volume, Packed,Red-Cell Volumes, Packed,Volume, Packed Erythrocyte,Volume, Packed Red-Cell,Volumes, Packed Erythrocyte,Volumes, Packed Red-Cell
D006454 Hemoglobins The oxygen-carrying proteins of ERYTHROCYTES. They are found in all vertebrates and some invertebrates. The number of globin subunits in the hemoglobin quaternary structure differs between species. Structures range from monomeric to a variety of multimeric arrangements. Eryhem,Ferrous Hemoglobin,Hemoglobin,Hemoglobin, Ferrous
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000090463 Iron Deficiencies Deficient amounts of iron in the body as a result of blood loss, diets deficient in iron, or an iron uptake or storage disorder. Hypoferritinemia,Iron Deficiency,Latent Iron Deficiency,Sideropenia,Deficiencies, Iron,Deficiencies, Latent Iron,Deficiency, Iron,Deficiency, Latent Iron,Hypoferritinemias,Iron Deficiencies, Latent,Iron Deficiency, Latent,Latent Iron Deficiencies,Sideropenias

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