Volume 5, Number 3—June 1999
Perspective
Iron Loading and Disease Surveillance
Eugene D. Weinberg
Table 4
Conditions that can compromise iron withholding (1,3)
| Excessive intake of iron through intestinal absorption |
| Behavioral and nutritional factors |
| Accidental ingestion of iron tablets |
| Adulteration of processed foods with inorganic iron or blood |
| Excessive consumption of red meats (heme iron) |
| Excessive intake of alcohol (HCl secretion enhanced) |
| Folic acid deficiency |
| Ingestion of ascorbic acid with inorganic iron |
| Use of iron cookware |
| Genetic and physiological factors |
| African siderosis |
| Asplenia (mechanism unknown) |
| Pancreatic deficiency of bicarbonate ions |
| Porphyria cutanea tarda |
| Regulatory defect in mucosal cells in hemochromatosis |
| Thalassemia, sicklemia, other hemoglobinopathies |
| Parenteral iron |
| Intramuscular and intravenous iron saccharate injections in excess |
| Multiple transfusions of whole blood or erythrocytes in excess |
| Inhaled iron |
| Exposure to amosite, crocidolite, or tremolite asbestos |
| Exposure to urban air particulates |
| Mining iron ore, welding, grinding steel |
| Painting with iron oxide powder |
| Tobacco smoking (1-2 µg iron inhaled per cigarette pack) |
| Release of body iron from compartments into plasma |
| Efflux of erythrocyte iron in hemolytic diseases |
| Efflux of hepatocyte iron in hepatitis |
| Deficit in iron withholding |
| Transferrin |
| Decreased synthesis |
| Congenital defect |
| Lack of dietary amino acids in kwashiorkor or in jejunoileal bypass |
| Decreased activity in acidosis |
| Lactoferrin |
| Neutropenia |
| Substitution of bovine milk or milk formula for human milk in nursling nutrition |
| Haptoglobin |
| Decreased synthesis in persons with haplotype 2-2 (28) |
