Iron absorption in HbH disease

We have reported that many cases of Hb H disease have a complication of iron overload without a history of multiple blood transfusion or prolonged iron therapy. We determined their iron absorption by 59Fe whole body counting in 13 such cases. Also 10 normal subjects were studied as a control group. The results showed a significant increase in iron absorption to 20.3%, in contrast to 6.9% in the normal control. This was further documented by their RBC incorporation (i.e. the percentage of orally administered) 59Fe recovered in the total RBC mass) on day 14 (13.7% vs 6.1%). The degree of ineffective erythropoiesis might not be severe considering their similar 59Fe utilization by RBC (i.e. the percentage of absorbed 59Fe recovered in the RBC) to the normals (86.3% vs. 84.3%).