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. 1970 Sep;11(9):727–731. doi: 10.1136/gut.11.9.727

Intestinal mucosal uptake of iron and iron retention in idiopathic haemochromatosis as evidence for a mucosal abnormality

L W Powell, C B Campbell, Elizabeth Wilson
PMCID: PMC1553114  PMID: 5473601

Abstract

The process of iron absorption has been studied in 23 patients with idiopathic haemochromatosis, in eight with iron-deficiency anaemia, and in 20 control subjects. The initial uptake of iron by the intestinal mucosa was estimated by administering 59Fe-ferric citrate during a standard meal together with a non-absorbable marker, 51Cr-chromic chloride. Body iron absorption (iron retained at 14 days) was measured by whole body counting with discriminant analysis to separate the two isotopes. Thus, the fraction of the initial mucosal uptake finally retained in the body was calculated (the mucosal transport index of iron).

In control subjects the mean values for mucosal uptake of iron and body iron absorption were 12·0 − SD 4·9% and 3·6 − SD 2·4%, with a mean mucosal transport index of 0·31 − SD 0·21. Mucosal iron uptake and body absorption were both considerably increased in the patients with iron-deficiency anaemia (33·5 − 15·6 and 29·8 − 17·0% respectively) and in the eight patients with idiopathic haemochromatosis treated by venesection therapy until the excess iron stores were removed (27·2 − 12·0 and 26·6 − 14·6% respectively). The mucosal transport index in all these subjects approached 1·0. Eight patients with haemochromatosis were studied before venesection therapy. The mucosal uptake of iron was within the normal range in all (mean 14·0 − 2·8%) but body iron absorption was increased in five (mean 9·1 − 4·8%). The mean mucosal transport index of iron was significantly increased in this group (0·62 − 0·28; p < 0·01).

The findings suggest that the increased iron absorption in subjects with idiopathic haemochromatosis results from an abnormality of the intestinal mucosa and not from altered intraluminal factors. However, whether the aberrant mucosal cell function is a primary defect in the cell or an acquired change, dependent on humoral or corporeal factors, is unknown.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astaldi G., Meardi G., Lisino T. The iron content of jejunal mucosa obtained by Crosby's biopsy in hemochromatosis and hemosiderosis. Blood. 1966 Jul;28(1):70–82. [PubMed] [Google Scholar]
  2. BIGGS J. C., DAVIS A. E. RELATIONSHIP OF DIMINISHED PANCREATIC SECRETION TO HAEMOCHROMATOSIS. Lancet. 1963 Oct 19;2(7312):814–814. doi: 10.1016/s0140-6736(63)90504-x. [DOI] [PubMed] [Google Scholar]
  3. Boender C. A., Verloop M. C. Iron absorption, iron loss and iron retention in man: studies after oral administration of a tracer dose of 59FeSO4 and 131-BaSO4. Br J Haematol. 1969 Jul;17(1):45–58. doi: 10.1111/j.1365-2141.1969.tb05663.x. [DOI] [PubMed] [Google Scholar]
  4. CONRAD M. E., Jr, CROSBY W. H. INTESTINAL MUCOSAL MECHANISMS CONTROLLING IRON ABSORPTION. Blood. 1963 Oct;22:406–415. [PubMed] [Google Scholar]
  5. CROSBY W. H. THE CONTROL OF IRON BALANCE BY THE INTESTINAL MUCOSA. Blood. 1963 Oct;22:441–449. [PubMed] [Google Scholar]
  6. Campbell C. B., Craswell P. W. A double isotope method to measure vitamin B 12 absorption. Australas Ann Med. 1970 Feb;19(1):42–46. doi: 10.1111/imj.1970.19.1.42. [DOI] [PubMed] [Google Scholar]
  7. Campbell C. B., Powell L. W. Use of Triton X-100 scintillant in a simple method for the simultaneous assay of 55Fe and 59Fe by liquid scintillation counting. J Clin Pathol. 1970 May;23(4):304–308. doi: 10.1136/jcp.23.4.304. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cattan D., Marche C., Jori G. P., Debray C. Le stock martial des villosités duodéno-jéjunales. L'absorption martiale vue par l'histologie. Nouv Rev Fr Hematol. 1967 Mar-Apr;7(2):259–270. [PubMed] [Google Scholar]
  9. Charlton R. W., Bothwell T. H. Hemochromatosis: dietary and genetic aspects. Prog Hematol. 1966;5:298–323. [PubMed] [Google Scholar]
  10. Davis P. S., Luke C. G., Deller D. J. Reduction of gastric iron-binding protein in haemochromatosis. A previously unrecognised metabolic defect. Lancet. 1966 Dec 31;2(7479):1431–1433. doi: 10.1016/s0140-6736(66)90594-0. [DOI] [PubMed] [Google Scholar]
  11. Figueroa W. G., Jordan T., Bassett S. H. Use of barium sulfate as an unabsorbable fecal marker. Am J Clin Nutr. 1968 Nov;21(11):1239–1245. doi: 10.1093/ajcn/21.11.1239. [DOI] [PubMed] [Google Scholar]
  12. Flendrig J. A., van Tongeren J. H., Hogeweg B., Verhoef C. W. Het meten van ijzerresorptie en ijzerretentie met een totale-lichaamsteller, in het bijzonder bij patiënten met idopathische hemochromatose. Ned Tijdschr Geneeskd. 1968 May 11;112(19):923–924. [PubMed] [Google Scholar]
  13. GANATRA R. D., SUNDARAM K., DESAI K. B., GAITONDE B. B. DETERMINATION OF ABSORPTION OF VITAMIN B12 BY A DOUBLE ISOTOPE TRACER TECHNIQUE. J Nucl Med. 1965 Jun;6:459–464. [PubMed] [Google Scholar]
  14. Kavin H., Charlton R. W., Jacobs P., Green R., Torrance J. D., Bothwell T. H. Effect of the exocrine pancreatic secretions on iron absorption. Gut. 1967 Dec;8(6):556–564. doi: 10.1136/gut.8.6.556. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Powell L. W. Changing concepts in haemochromatosis. Postgrad Med J. 1970 Apr;46(534):200–209. doi: 10.1136/pgmj.46.534.200. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Powell L. W., Thomas M. J. Use of diethylenetriamine penta-acetic acid (D.T.P.A.) in the clinical assessment of total body iron stores. J Clin Pathol. 1967 Nov;20(6):896–904. doi: 10.1136/jcp.20.6.896. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. SAYLOR L., FINCH C. A. Determination of iron absorption using two isotopes of iron. Am J Physiol. 1953 Feb;172(2):372–376. doi: 10.1152/ajplegacy.1953.172.2.372. [DOI] [PubMed] [Google Scholar]
  18. Seife B., Shils M. E., Amster G. The estimation of fat absorption in man with the use of double isotopes 131BaSO4 and 131-iodine triolein. J Lab Clin Med. 1969 Jul;74(1):119–128. [PubMed] [Google Scholar]
  19. Smith P. M., Godfrey B. E., Williams R. Iron absorption in idiopathic haemochromatosis and its measurement using a whole-body counter. Clin Sci. 1969 Oct;37(2):519–531. [PubMed] [Google Scholar]
  20. Smith P. M., Studley F., Williams R. Postulated gastric factor enhancing iron absorption in haemochromatosis. Br J Haematol. 1969 May;16(5):443–449. doi: 10.1111/j.1365-2141.1969.tb00422.x. [DOI] [PubMed] [Google Scholar]
  21. Weintraub L. R., Weinstein M. B., Huser H. J., Rafal S. Absorption of hemoglobin iron: the role of a heme-splitting substance in the intestinal mucosa. J Clin Invest. 1968 Mar;47(3):531–539. doi: 10.1172/JCI105749. [DOI] [PMC free article] [PubMed] [Google Scholar]

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