Effect of Iron-deficiency Anæmia on the Metabolism of the Heterogenic Hæmoglobins in Sickle Cell Trait

HÆMOGLOBIN S is found in a concentration of 35–45 per cent of the total hæmoglobin in most individuals with sickle cell trait under non-stress conditions 1,2 . It is believed that the relative concentrations of the heterogenic hæmoglobins, hæmoglobin S and hæmoglobin A, in these individuals remain fairly constant throughout life. However, on rare occasions, changes in these relative concentrations have been demonstrated. In 1956, Zuelzer, Neel and Robinson 3 described an 8-month-old infant with sickle cell trait and severe iron-deficiency anæmia in whom hæmoglobin S could not be demonstrated by paper electrophoresis until the anæmia had been corrected with iron therapy. More recently, Heller, Yakulis, Epstein and Friedland 4 have described a patient with sickle cell trait and coexistent megaloblastic anæmia in whom the hæmoglobin S concentration increased from an initial level of 10.6 per cent to a concentration of 38.5 per cent following therapy with folic acid.