CHRONIC MUCO-CUTANEOUS CANDIDIASIS: ASSOCIATED ABNORMALITIES OF IRON METABOLISM

Abstract

Summary.— Forty-six patients with chronic muco-cutaneous candidiasis were ascertained and classified into 4 groups on a clinico-genetic basis. One of these groups contains a newly described entity called familial chronic muco-cutaneous candidiasis. Tests of specific immune responses, related to lymphocyte function, gave abnormal results in over half the patients investigated, but the range of disturbance of function could not be precisely related to the clinico-genetic classification. Twenty-three out of 31 patients fully investigated showed evidence of iron deficiency as judged by low serum iron and decreased iron stores. Eight had hypochromic anaemia, including all 6 patients in the severely affected group. Nine out of 11 patients treated with iron showed significant clinical improvement and this effect was confirmed by a small controlled trial irrespective of the presence of varied abnormal immunological responses. The possibility is considered that the disturbance of iron metabolism might be the fundamental aetiological factor in many of these patients and that the other abnormalities, such as those of specific immune responses, may be secondary. The hypothesis of a possible link between nutritional factors and the immune response is outlined.