Oxidative haemolysis in protein malnutrition.

A study of the haemolytic anaemia observed in protein-energy malnutrition (PEM) in Kivu disclosed the following results. The in vitro resistance to oxidative aggressions of PEM patients' erythrocytes was decreased: when incubated with acetylphenylhydrazine, a higher percentage of the cells showed Heinz bodies, as compared with erythrocytes of local controls. Normal or increased activities were found for certain erythrocyte enzymes involved in the detoxification of activated oxygen: glucose-6-phosphate dehydrogenase, 6-phosphogluconate dehydrogenase and glutathione reductase. The level of reduced glutathione was not decreased. Reduced activities were observed for two enzymes containing trace elements: glutathione peroxidase and superoxide dismutase. It is suggested that the shortened erythrocyte lifespan observed in PEM patients corresponds to an oxidative process which results from the decrease of both enzyme activities. The hypothesis that depletion of trace elements could be responsible for the decreased activity of those enzymes is discussed.