An inappropriate erythropoietic response to iron deficiency anaemia in the elderly

• Published in: Clinical and laboratory haematology Vol. 17; no. 4; p. 317
• Main Authors: Matsuo, T, Kario, K, Kodoma, K, Asada, R
• Format: Journal Article
• Language: English
• Published: England 01-12-1995
• Subjects: Aged; Aged, 80 and over; Anemia, Iron-Deficiency - blood; Autoanalysis; Erythropoiesis - physiology; Female; Flow Cytometry; Humans; Male; Middle Aged; Reproducibility of Results; Reticulocyte Count
• ISSN: 0141-9854
• DOI: 10.1111/j.1365-2257.1995.tb01271.x

This study was carried out to clarify the features of iron deficiency anaemia in the elderly. Subjects were chosen from residents undergoing an annual health check in a home for the aged and the features of anaemia in the elderly were compared with those in middle-aged adults under 60 years old. The red cell count, red cell size and haemoglobin content in an elderly group with iron-deficiency anaemia did not differ from those in middle-aged adults. No significant differences of the serum ferritin and iron levels were noted between the two groups. Total iron binding capacity was higher in the middle-aged adults than in the elderly, while the reticulocyte count was significantly lower in the elderly group. Immature reticulocytes showing a considerable amount of residual RNA by flow cytometry with fluorescent staining were also lower in the elderly group than in the middle-aged adults. Serum erythropoietin levels in both groups were significantly higher than in non-anaemic age-matched controls and no difference in erythropoietin levels was noted between them. The ratio of the reticulocyte count to the log-transformed erythropoietin level was low in the elderly group with iron-deficiency anaemia compared with the middle-aged adults with iron deficiency anaemia. The same result was seen when the immature reticulocyte count was related to the log-transformed erythropoietin level. These findings suggest that the red cell production response to erythropoietin in the elderly with iron-deficiency anaemia might be inappropriate compared with both non-anaemic and anaemic middle-aged adults.