Bone marrow and chelatable iron in patients with protein energy malnutrition

S Afr Med J. 1996 Nov;86(11):1410-3.


Objectives: To examine the iron status of malnourished children by comparing bone marrow iron deposits in children with protein energy malnutrition with those in well-nourished controls, and measuring chelatable urinary iron excretion in children with kwashiorkor.

Design: Bone marrow iron was assessed histologically in postmortem specimens from children with kwashiorkor or marasmus, and from controls. Twenty-four-hour urinary iron was measured in children with severe kwashiorkor, half of whom received 10 mg/kg of intramuscular desferrioxamine (DFO) on admission.

Setting: Red Cross War Memorial Children's Hospital, Cape Town.

Subjects: Thirteen children with kwashiorkor, 6 with marasmus and 16 well-nourished children underwent bone marrow examination. Urinary iron excretion was assayed in 17 children with kwashiorkor.

Results: Stainable iron was present in the bone marrow of half the children with kwashiorkor but in only 1 child in each of the other groups. The median iron excretion was 945.5 micrograms/24 hours in the DFO group compared with 28.5 micrograms/24 hours in the non-DFO group.

Conclusions: There is an apparent excess of iron which may predispose to bacterial infections and free radical-mediated injury in children with kwashiorkor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Marrow / chemistry*
  • Bone Marrow / pathology
  • Child
  • Child, Preschool
  • Deferoxamine / therapeutic use
  • Free Radicals / adverse effects
  • Humans
  • Infant
  • Iron / urine*
  • Iron Overload / drug therapy
  • Kwashiorkor / complications
  • Male
  • Protein-Energy Malnutrition / complications


  • Free Radicals
  • Iron
  • Deferoxamine