Increased Hemolysis after Intramuscular Iron Administration in Patients with Paroxysmal Nocturnal Hemoglobinuria

Four patients with PNH were described who developed accelerated activity of their disease after the intramuscular administration of iron-dextran for treatment of iron deficiency. This was considered to reflect a unique effect of iron on PNH erythrocytes. It was postulated that this effect resulted from cell damage caused by iron catalyzed peroxidation of erythrocyte lipids, a reaction to which PNH erythrocytes could be unusually susceptible by virtue of an increased content of unsaturated fatty acids or pro-oxidants or decreased content of antioxidants.