Iron stores in health and disease: Bone-marrow studies in 1134 children in Punjab, India

Abstract

Bone-marrow haemosiderin was assessed semi-quantitatively in a series of 1134 children of all ages: 180 children were healthy, and the remaining 954 were suffering from a variety of disorders, mainly chronic. Iron deficiency was diagnosed if iron stores, as reflected by marrow haemosiderin, were low or absent. With this criterion, iron deficiency was present in 56% of the healthy children. Iron deficiency was present in 81% of all the ill children; in those with malnutrition, the incidence was 85%, and in those with chronic infections, 83%. Other commonly used criteria of iron deficiency were evaluated at the same time, including red cell film appearances, red cell indices, serum iron level, and percentage saturation iron-binding capacity. Of these, the presence of hypochromia of red cells proved the most generally useful indicator of iron deficiency, while those based on serum iron levels often proved misleading.