Treatment of a unique anemia in patients with IDDM with epoetin alfa.
OBJECTIVE
To identify and treat a unique form of anemia in patients with long-term IDDM.


METHODS
Patients with IDDM, unexplained symptomatic anemia, and serum creatinine levels of < 177 mumol/l (2.0 mg/dl) were treated with epoetin alfa (Procrit, Ortho Biotech, Raritan, NJ), 50 U/kg three times weekly, subcutaneously, to reach a target hematocrit of 38-40%. Baseline serum erythropoietin titers were measured before drug therapy.


RESULTS
Six patients were treated with epoetin alfa. Median age of the group was 74 years, with IDDM being diagnosed for a median of > 20 years. All patients had symptoms of anemia with a median hematocrit of 28.9% (range 27-31). Compared with iron deficiency control patients, the group had a limited erythropoietin (EPO) response to the degree of anemia. All patients showed increases in hematocrit, median peak of 40.9%, with median time-to-peak response of 12 weeks. Baseline symptoms of anemia resolved in all patients. No adverse effects were noted during the treatment period.


CONCLUSIONS
There is a unique form of anemia in patients with long-term IDDM and clinically normal renal function who respond to low-dose epoetin alfa therapy. The rapid response to therapy and depressed baseline erythropoietin titers suggest the anemia is due to a lack of endogenous EPO release.
Rarick
M U
MU
Division of Hematology/Oncology, Kaiser Permanente, Portland, Oregon 97227, USA. rarickma@chr.mts.kpnw.org
Espina
B M
BM
Colley
D T
DT
Chrusoskie
A
A
Gandara
S
S
Feinstein
D I
DI
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000188:drug therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use*; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000378:metabolism; D011994:Recombinant Proteins; D016896:Treatment Outcome
D000068817:Epoetin Alfa; D004921:Erythropoietin; D006442:Glycated Hemoglobin; D006397:Hematinics; D011188:Potassium; D011994:Recombinant Proteins