Blood Copper and Iron in Addison's Disease

Abstract

In a series of anemias previously reported, 1 , 2 we have shown that with few exceptions that low blood iron was accompanied by an increase in blood copper. We report now 3 cases of Addison's disease, a comparatively rare condition accompanied by secondary anemia and characterized in most instances by an increased degree of pigmentation of the skin. The fact that the copper content of the skin has recently been closely associated with increased skin pigmentation 3 , 4 , 5 makes these determinations of added interest.

We have made iron and copper analyses on the blood of 3 patients with Addison's disease. Iron estimations were made by a dry ashing method using potassium thiocyanate as the reagent, and copper determinations by a modification of McFarlane's method, using sodium diethyldithiocarbamate as the reagent. 1 ,^6-9

In comparison with our figures obtained for normal individuals, the blood findings in the three patients indicate the presence of anemia. The blood picture in the two female patients shows a hypo-erythroeythemia and hypoferronemia accompanied by hyper-cupremia. The blood in the male patient reveals a hypo-erythrocy-temia and hypoferronemia, the copper content being slightly higher than the average but yet within the normal range.

In the 3 cases of Addison's disease reported in this communication we are unable to deduce any correlation between the copper content of the blood and the amount of skin pigmentation. Mr. S., who possessed the greatest degree of pigmentation of the three, had the least blood copper content. Mrs. C, who displayed the least skin pigmentation, had 37% more blood copper than Mr. S. However, it must be remembered that skin pigmentation in Addison's disease is a very slow and gradual process, and as a result the blood copper may show no deviation from the normal.

We wish to thank Dr. Russel M. Wilder, of the Mayo Clinic, for permission to make copper and iron determinations on blood samples from the 3 patients mentioned in this paper.