In the first report, it was revealed that the anemia of rheumatoid arthritis had a significant correlation to ESR and Stage of the disease in the group of above-50-years-old women.
Accordingly, hemoglobin (Hb), Serum iron (SFe), serum total iron binding capacity (TIBC), serum copper (SCu) and serum total protein (TP) were measured in 44 cases of above-50-years-old female patients.
The materials in this study were biassed to the patients having more intense inflammatory sign than the patients in the first report, because they were selected from the patients having intra-articular injections of corticosteroid hormone.
Blood specimens were obtained between 10:00 a.m. and 12.00 a.m. and the results were compared with normal values under the same condition in consideration of the diurnal change.
The average values of these specimens are shown in Table 3. Table 4 shows a significant decrease in Hb, SFe and TIBC, and a significant increase in SCu, as compared with the values of normal young women.
The relation of these values to the state of the disease was analysed statistically (as shown in Table 5. 6. 7. 8. 9. 10.).
It was revealed that the higher the ESR rose, the more marked appeared the feature of the infectious anemia as suggested by Wintrobe previously.
On the contrary, as the S+age of the disease progressed, the blood changes had a tendency to show a feature of iron deficiency anemia, though there was no statistically significant proof except a negative partial correlation between Hb and Stage.
Stage of the disease, which is classified mainly by the roentogenological findings of the affected joints, related closely to the duration of the disease and proved independent to ESR. (Table 8).
There are some reports, which suggest that iron deficiency play a part in the anemia of rheumatoid arthritis. Thus the anemia of rheumatoid arthritis is considered to belong basically to an iron deficiency anemia which progresses as the Stage of the disease advances and which is modified by the inflammatory process adding the feature of infectious anemia.
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