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Anemia in Erythropoietic Protoporphyria

Micheline M. Mathews-Roth, MD
JAMA. 1974;230(6):824. doi:10.1001/jama.1974.03240060014013.
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To the Editor.—  During the course of our recently reported study on β-carotene treatment of erythropoietic protoporphyria (EPP) (228:1004, 1974), we found that some patients had some degree of anemia as defined by the criteria established by the AMA Council on Foods and Nutrition (203:407, 1968). Since EPP was thought to have no hematological abnormality,1,2 we present our findings to suggest that a mild degree of anemia may be more widespread among patients with EPP than had been thought.The Table shows the incidence of anemia in our patients. Calculation of red blood cell indices in 12 of the 19 patients classified as anemic showed that the mean corpuscular volume was decreased in seven patients, and the mean corpuscular hemoglobin count was within the lower half of the normal range of 32 to 36 (31 to 33); this would suggest the presence of a microcytic-normochronic anemia. Examination of blood


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