Case report 432: Granulocytic sarcoma (GS), with hypereosinophilic syndrome (HES).
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Biomedical subjects
Publications and source records attributed to M R Beamish.
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The concentration of ferritin in serum gives a quantitative measure of the amount of storage iron in normal subjects and those with iron deficiency or overload. The mean level in normal men is 69 ng/ml, compared with 35 ng/ml in normal women. A concentration below 10 ng/ml is associated with a low transferrin saturation and iron-deficient erythropoiesis.
An evaluation of iron metabolism has been carried out in 23 untreated patients with Hodgkin's disease and 6 patients with other lymphomata. The reduction in red cell life span is related to the stage of the disease. There is an almost universal impairment of iron release from the reticuloendothelial system with a consequent sideropenia and failure of iron delivery to the bone marrow for erythropoiesis. This defect is found in all stages of the disease and is not related to systemic symptoms.
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An immunoradiometric assay for human ferritin has been developed. Concentrations of ferritin in the serum of male and female controls and patients with iron deficiency and iron overload were measured.Male controls were found to have a significantly higher mean concentration of serum ferritin than females. Patients with iron deficiency had significantly lower levels than normals of either sex and patients with iron overload had greatly elevated serum ferritin concentrations. It is thought that the serum ferritin concentration may reflect the iron stores of the body.
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The utilization of iron dextran was investigated in normal subjects, in patients with iron-deficiency anaemia, and in anaemias associated with rheumatoid arthritis, reticulosis, and uraemia. Utilization of iron for haemoglobin formation at 14 days was found to be depressed in patients with rheumatoid arthritis, reticulosis, and uraemia, but when a concomitant iron-deficiency anaemia was present utilization was significantly increased. When iron dextran is used to treat anaemias in such conditions an optimum therapeutic response will be obtained only when bone marrow iron stores are absent.
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