Anemia in acute phase of spinal cord injury

Anemia is a frequent complication during the acute phase of spinal cord injury (SCI), even in the absence of detectable blood loss. Since an improved understanding of the etiology of anemia in this population is a prerequisite to its ultimate prevention, a prospective study was conducted on 28 persons with SCI whose lesions were between C3 and C7. The injuries were either neurologically complete, incomplete with sensory sparing only, or incomplete with nonfunctional motor preservation. Laboratory profiles were obtained during the first few weeks postinjury. No persons had below-normal plasma volumes, while 9% had below-normal blood volumes. However, 82% had below-normal red cell masses, 25% had below-normal serum erythropoietin levels, and 11% had below-normal reticulocyte counts. Other below-normal values included erythrocyte count (75%), hemoglobin (79%), hematocrit (71%), mean corpuscular volume (11%), mean corpuscular hemoglobin (11%), serum iron (50%), total iron binding capacity (86%), iron saturation (50%), serum total protein (57%), serum albumin (89%), serum globulin (32%), and serum transferrin (79%). Most persons (71%) were found to have normochromic, normocytic anemia, although 14% had normochromic, microcytic anemia. Only 14% did not develop anemia. Although these cases of anemia were not severe enough to require transfusions, they might be an important factor in the development of other secondary complications and may combine with other nutritional and hematologic deficiencies to prolong the rehabilitation process.