VIRGINIA MINNICH’s research while affiliated with Washington University in St. Louis and other places

The effect of four varieties of clay and of one soil sample upon ⁵⁹FeSO4 and ⁵⁹Fe-labeled hemoglobin absorption was investigated in normal and iron-deficient subjects. The clays differed in effect depending upon their cation exchange capacity (CEC). Clay from Turkey with a high CEC was more effective in blocking iron absorption than were three clays with lower CEC values. Turkish clay also decreased the amount of ⁵⁹Fe-labeled hemoglobin absorbed. The effect can be explained by time transitional nature of iron, which exchanges for Ca, Mg, Mn, Na, K, and H ions with the formation of nonabsorbable iron compounds. Magnesium oxide was extremely effective in preventing iron absorption. The cation exchange capacity of antacids which contain magnesium compounds may have some clinical significance because of their reaction with iron The effect of clay and soil on iron absorption may not be the sole factor in the production of anemia in geophagia, but it could be contributory. Nutritional and parasitic factors are usually involved as well.

The relationship of anemia to pica was investigated in 182 Turkish villagers. The presence of anemia was detected by hemoglobin determinations and stained peripheral blood films. The average hemoglobin concentration of sixty-nine control subjects of all ages without a history of pica was 13.0 gm. per 100 ml.; 17 per cent were anemic. The average hemoglobin concentration of seventy-three persons of all ages with pica was 9.8 gm. per 100 ml. and 64 per cent of this group was anemic. Anemia associated with pica appeared to be reversible since the average hemoglobin level of forty subjects who were former dirt or clay eaters was 12.6 gm. per 100 ml. and only 20 per cent had anemia. A further breakdown of anemia related to age and type of pica is included. Factors which might influence the cause for pica are discussed. Clay eating in women appears to be largely habit; many factors are probably involved in dirt and plaster pica.

Thalasscmia-hemoglobin K disease is described in a 6 years old girl of Eli-Turks. The patient displayed a moderately severe form of the disease and had an associated infection of brucellosis. The genetic studies revealed that the father had classical thalassemia minor and the mother was a carrier for hemoglobin E. Three siblings were found to be heterozygous for hemoglobin E, one for thalassemia and one was normal. This is the first report of thalasscmia-hemoglobin E disease in Eti-Turks and the second from Turkey.