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Masked Sideropenia in Hepatic Fibrosis Associated with Bilharziasis

Serum iron concentration and iron absorption tests were made in 20 healthy controls and in 40 patients with hepatic fibrosis associated with Schistosoma mansoni infection who had no anemia. In normal people the fasting serum iron varied from 75 to 174 micrograms per 100 ml, and after administration of ferrous gluconate the serum iron increased only slightly (iron saturation). In patients with bilharzial hepatic fibrosis the fasting serum iron was low in 22 percent and normal in 8 percent, and in both these groups, i.e., 30 percent, the serum iron exceeded the maximum empirical value of about 200 micrograms per 100 ml after oral administration of ferrous gluconate; this indicated the presence of an iron deficiency state (masked sideropenia). In the remaining 70 percent the fasting serum iron and the iron absorption test were normal (iron saturation).