Sodium, potassium, water, and haemoglobin in the packed red cells of severe thalassaemia

Abstract

SYNOPSIS Sodium, potassium, water, and the mean corpuscular haemoglobin concentration were determined in the packed erythrocytes of children with severe thalassaemia. The concentration of sodium in the packed red cells was higher than normal in a significant proportion of children with thalassaemia whereas potassium in the packed cells and sodium and potassium in the plasma were normal.On average, the cell water content was a little higher and the mean corpuscular haemoglobin concentration a little lower than normal.The cation concentrations in the packed cells of thalassaemia are compared with those in other anaemias. Similarities are pointed out between the sodium concentrations in the packed cells of thalassaemia and those from the foetus and children suffering from malnutrition.Previous work has shown that the packed erythrocytes in many anaemias contained abnormal amounts of water and cations, chiefly potassium. The concentration of potassium in the packed cells was increased in microcytic anaemias, paralleling an increase in cell water (Maizels, 1936;McCance and Widdowson, 1956). In macrocytic anaemias the small increase in potassium reported by Maizels (1936) and Iyer (1958) was not confirmed by Bertcher and Meyer (1952) and was not always accompanied by a rise in the cell water.The packed erythrocytes in spherocytic anaemias, congenital (Maizels, 1936; Selwyn and Dacie, 1954) or acquired (Selwyn and Dacie, 1954), have been shown to contain less potassium and less water than do normal cells.In congenital, non-spherocytic haemolytic anaemia the concentration of potassium and the water content of the packed red cells were high in the cases with marked macrocytosis and reticulocytosis (type I) and normal in the cases with only occasional macrocytes and ovalocytes (type II) (Selwyn and Dacie, 1954). These deviations from normal in type II have been attributed to a high proportion of reticulocytes which are known to contain more Received for publication 20 March 1961 'Supported by a grant from the Soci&t6 des Produits Nestl6, S.A., Vevey, Switzerland. potassium and more water than do mature erythrocytes (Granick, 1949;Keitel, Berman, Jones, and MacLachlan, 1955;Ponder, 1948).In all these anaemias the concentration of sodium in the packed erythrocytes was normal.The red cell potassium content was slightly low in sickle cell anaemia. During sickling the cells lost potassium and gained sodium without appreciable change in the total cation concentration or the water content (Tosteson, 1955; Tosteson, Carlsen, and Dunham, 1955; Tosteson, Shea, and Darling, 1952).Experimental post-haemorrhagic anaemia in the dog and the rabbit resulted in a rise of the concentration of potassium and, sometimes, that of magnesium in the packed erythrocytes. A greater rise of these cations was observed in the haemolytic anaemia following the administration of phenylhydrazine and was thought to reflect the high proportion of reticulocytes in both these anaemias (Henriques and 0rskov, 1939).No abnormality was found in the con...

Spectrochemical Analysis of Sodium, Potassium, Calcium, Magnesium, Copper, and Zinc in Normal Human Erythrocytes*

“…This is probably due to wide variations in instrument blank values that were encountered occasionally with the Coleman nitrogen analyzer in our early studies. In this respect our experience has been similar to that of Flokstra and Nodolski (38 21 3,358 93 3,512 14 3,371 21 3,729 22 3,500 35 3,401 12 3,752 20 3,627 47 3,349 30 3 Solomon (11) and Selwyn and Dacie (9), but it is 13% higher than the results obtained by Czaczkes and co-workers (13), 6% lower than the mean value found by McCance and Widdowson, and 18% less than the value given by Choremis and associates (12) in children (Table VI). The discrepancy in results is probably due to minor differences in the composition of standards, in excitation conditions, or in the instruments used in the analysis.…”

“…The average sodium concentration in centrifuged erythrocytes has been reported to be from as low as 168 MAg per g (4) to as high as 443 ug per g (5), and several textbooks (6)(7)(8) give a value of approximately 400 ug per g, which is not in accord with the results of recent investigation (9)(10)(11)(12)(13). In a few studies (9-13) correction for sodium in trapped plasma has been taken into consideration, but in others (14)(15)(16)(17)(18)(19)(20)(21) it has been neglected.…”

Erythrocyte Electrolyte Content and Sodium Efflux in Chronic Renal Failure

“…These include hyperthyroidism [21], severe cardiac failure [19], sick cell syndrome [17], metabolic alkalosis [22], thalassaemia [23], and Na depletion. Czaczkes et al [19] found RBC-Na to be low in uraemia, but Welt et al [24] described a group of patients with very high RBC-Na levels.…”

The Phospholipids of Normal and Thalassaemic Erythrocytes

“…Kates, Allison and James (1961) have reported an abnormal ratio of phosphatidyl ethanolamine to lysophosphatidyl ethanolamine in red cells from two patients with hereditary spherocytosis. De Gier, van Deenen, Geerdink, Punt and Verloop (1961), however, failed to confirm this.…”

“…The increase in cell Na' was confirmed by Houtsmdler (1959), who found also an increase in red cell K+. Choremis, Nicolopoulos, Metaxotou and Moschos (1965) described a decreased cholinesterase activity in the red cells of thalassaemics.…”