Ancylostomotic anemia: a contribution to the study of its physiopathology

Abstract

Seventeen ancylostomotic patients was studied and several hematological parameters: hemoglobin level, serum iron level and transferrin, erythrocyte count, hematocrit, mean corpuscular volume (VCM) and mean corpuscular hemoglobin (HCM) was established. This study also included the determination of several erythrokinetic data such as plasma iron turnover and red cell iron turnover. Radioisothopic assays also permitted the estimation of blood volume and hemoglobin lost through feces, as well as the amount of iron absorbed from this hemoglobin. The authors also established the intensity of the patient's infection by egg and worm counts. The patients presented no evident nutritional abnormality. Iron deficiency was the common factor found among those who had anemia, and it constitutes the physiopathologic basis of ancylostomotic anemia. The worms fixed on the intestinal epithelium suck the host's blood and this long-term blood spoliation produces anemia. The volume of blood lost is generally proportional to the degree of infection, but the fall in the patient's hemoglobin level was found to be independent of the spoliated blood volume. The great amount of iron which is absorved from the hemoglobin shed into the feces contributes to the later establishment of anemia as compared to that of other hemorrhages, as for instance, vaginal hemorrhages. The anemic patients were submitted to blood transfusions and thereafter presented an immediate although temporary clinical and laboratorial improvement. A steady clinical improvement, however, was established only after adequate worm therapy.