Saccharated iron oxide given intravenously has recently been used successfully by several groups of British investigators for the treatment of iron deficiency anemia.1 The therapeutic response has been uniformly good ; reactions have been both infrequent and mild. It is surprising that the preparation can be injected with relative safety since all other forms of iron administered parenterally have caused reactions so severe that their use had to be abandoned ; these include ferrous citrate, iron citrate green, ferrous gluconate, ferrous ascorbate, colloidal ferric hydroxide and colloidal ferric oxide.2 The toxic manifestations commonly observed with the last two compounds were nausea, vomiting, abdominal and lower back pain, lacrimation, nasal stuffiness, headache, flushing and swelling of the face, swelling and stiffness of the tongue, paresthesias, fever, rapid fall in systolic blood pressure, substernal pain and a sense of impending death. The earlier studies with these therapeutically unsatisfactory iron preparations, however, had demonstrated that injected iron is almost quantitatively converted into hemoglobin ; and when the amount of injected iron is large (0.608 to 1.32 Gm.) the reticulocyte response is dramatic and the rate of hemoglobin regeneration maximal.2b For these reasons the discovery of a safe, effective form of parenteral iron therapy must be regarded as important. At the same time, it should be emphasized that there are few legiti¬ mate indications for the injection of iron since almost all iron-deficient patients respond well to oral therapy. Furthermore, if the dose is not carefully calculated, much larger amounts of saccharated iron oxide may be given than are needed to correct the deficiency, and excessive, potentially harmful deposits of iron in tissues may result.The present report (1) describes the clinical and hematological responses of 10 patients with hypo-chromic microcytic anemia to the intravenous adminis¬ tration of saccharated iron oxide, (2) emphasizes the potential toxic effects of overdosage and (3) defines the indications for the use of saccharated iron oxide.
THERAPEUTIC RESPONSE TO INTRAVENOUSLY ADMIN¬ ISTERED SACCHARATED IRON OXIDESaccharated iron oxide was given intravenously to 10 patients with hypochromic microcytic anemia. (See the accompanying table). The primary cause of iron deficiency in each instance was hemorrhage either from the uterus or from the gastrointestinal tract. Hypochlorhydria and poor diet were undoubtedly important contributory causes in several patients. Initial hematological values showed the following range of variations : red blood cells, 3.14 to 5.17 million cells per cubic milli¬ meter; hemoglobin 5.8 to 9.8 Gm. per 100 cc, and mean corpuscular hemoglobin concentration, 25 to 31 per cent.Three different preparations of saccharated iron oxide, each made by a different manufacturer, were used.3 They contained 100 mg. of iron per 5 cc. Accord¬ ing to Mannieh and Rojahn,4 saccharated iron oxide is a negatively charged colloidal solution of ferric ...
