ABSTRACT
In Egypt human fascioliasis is an increasing health problem especially in the Nile Delta. This study was conducted on 35 anaemic patients with fascioliasis, 20 anaemic patients with schistosmiasis [parasitic control group] and 10 persons [healthy control group].Serum erythropoietin "EPO" and ferritin were measured using a sandwitch ELISA technique, also other ferrokinetic parameters were done .In patients with fascioliasis, EPO level [19.05 +/- 13.3 mU/ml] was significantly higher than those of healthy control [7.23 +/- 1.6 mU/ml] and of schistosomiasis [12.3 +/- 2.85 mU/ml] groups [P < 0.001]. Serum ferritin was significantly higher in fascioliasis group [384.8 +/- 51.1 ng/ml] than in schistosomiasis [174.7 +/- 83.4 ng /ml] and in healthy control [117.5 +/- 29.5 ng/ml] groups. [P < 0.001]. Other ferrokinetic studies showed low serum iron, subnormal transferrin saturation, low total iron binding capacity, inspite of adequate iron stores shown by high serum ferritin, these findings together with normal reticulocytic count were similar to those found in the anaemia of chronic disorders.The presence of anaemia inspite of high EPO level and adequate body iron stores may be explained by unresponsiveness of bone marrow to high EPO level which may be due to blocking the action of EOP by some cytokines as interleukin-1, tumour necrosis factor, and gamma interferon which were proved to be abundant in hepatic fascioliasis, or it may be due to an inhibition of bone marrow by large amount of proline which is usualy present in hepatic fasioliasis after treatment, cases of hepatic fascioliasis showed a good improvement of all parameters which were more or less comparable to those of healthy control. Normocytic normochromic anaemia