Recovery of pancreatic beta-cell function in hemochromatosis: combined treatment with recombinant human erythropoietin and phlebotomy.
A patient with diabetes mellitus caused by secondary hemochromatosis was treated using recombinant human erythropoietin and phlebotomy. A total of 12 g of iron had been infused in the patient because of iron deficiency anemia. Blood glucose level was 17.3 mmol/L, and hemoglobin A1c level was 9.0% at admission. He was treated using phlebotomy (400 mL per week), along with subcutaneous injection of 3,000 U of recombinant human erythropoietin three times a week. After approximately 100 days, a total of 5,500 mL of blood (2.75 g iron) could be removed. Serum ferritin level decreased from 10,000 micrograms/L to 4,807 micrograms/L. Fasting and maximum serum C-peptide immunoreactivity values during 100-g oral glucose tolerance tests were improved from 0.14 nmol/L to 0.42 nmol/L and from 1.84 nmol/L to 2.61 nmol/L, respectively. This case suggests that pancreatic beta-cell recovers in diabetes caused by hemochromatosis by reducing iron overload during a short period.
Inoue
Y
Y
Department of Endocrinology, Toranomon Hospital, Tokyo, Japan.
Nakanishi
K
K
Hiraga
T
T
Okubo
M
M
Murase
T
T
Kosaka
K
K
Miyakoshi
S
S
Mutoh
Y
Y
Kobayashi
T
T
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D003131:Combined Modality Therapy; D003920:Diabetes Mellitus / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D004921:Erythropoietin / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007501:Iron / Q000009:adverse effects / Q000097:blood; D019190:Iron Overload / Q000628:therapy; D007515:Islets of Langerhans / Q000473:pathology / Q000502:physiology*; D008297:Male; D018962:Phlebotomy; D011994:Recombinant Proteins
D001786:Blood Glucose; D002096:C-Peptide; D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron