[Aplastic anemia complicated with secondary hemochromatosis after allogenic bone marrow transplantation].
We report a case of aplastic anemia complicated with secondary hemochromatosis after allogenic bone marrow transplantation (BMT). A 29-year-old man was diagnosed as having aplastic anemia at the age of 8. At the age of 28, BMT was performed from his HLA-identical sister. Total volume of blood transfusion before BMT was about 28,000 ml, and in three months after BMT was 8,000 ml. The transplantation was successful, but one month after BMT, dry eyes, skin pigmentation and hepatomegaly appeared. Serum bile duct enzymes and ferritin also increased remarkably. Moreover after thirteen months, glucose tolerance impaired seriously. Abdominal computed tomography (CT) revealed atrophic pancreas and an increased CT density in the liver and the tail of the pancreas. A large amount of iron deposition were also found in liver and stomach biopsy specimens. We concluded that diabetes mellitus was due to secondary hemochtomatosis in the present case. There is a possibility that tissue damage due to iron deposits may have been accelerated through BMT in this patient with a history of many blood transfusions.
Second Department of Internal Medicine, Shinshu University School of Medicine.
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T
Oguchi
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K
Kitano
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Kobayashi
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H
Saito
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Okamoto
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K
Kiyosawa
D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications* / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003920:Diabetes Mellitus / Q000209:etiology; D006432:Hemochromatosis / Q000209:etiology*; D006801:Humans; D008297:Male; D065227:Transfusion Reaction; D014184:Transplantation, Homologous