title: Successful treatment of Diamond-Blackfan anemia with metoclopramide.
abstract: Diamond-Blackfan anemia (DBA) is a congenital anemia characterized by a low reticulocyte count, the absence or severe reduction of hemoglobin-containing cells in the bone marrow, and normal megakaryocytic and granulocytic differentiation. Although the anemia may initially respond to corticosteroid therapy, many patients require lifelong red blood cell (RBC) transfusion, leading to infectious complications and iron overload. Metoclopramide has recently been used to treat DBA. Treatment with metoclopramide induces the release of prolactin from the pituitary and stimulates erythropoiesis. For these reasons, we used metoclopramide to treat a 20-year-old man with DBA refractory to low and high doses of corticosteroids, cyclosporin A, and tacrolimus (FK506). The hemoglobin and hematocrit slowly increased, and he has remained asymptomatic and transfusion-independent for 8 months. Metoclopramide therapy should be considered in patients with refractory DBA before treatment-related complications develop.
authors.affiliation: Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan. makiyama@jikei.ac.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Akiyama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Yuza
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yokoi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Ariga
authors.forename: Kohji
authors.initials: K
authors.lastname: Fujisawa
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Hoshi
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Eto
mesh_terms: D000328:Adult; D029503:Anemia, Diamond-Blackfan / Q000097:blood / Q000188:drug therapy*; D018492:Dopamine Antagonists / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D011388:Prolactin; D017701:Reticulocyte Count; D016896:Treatment Outcome
chemical_list: D018492:Dopamine Antagonists; D006454:Hemoglobins; D011388:Prolactin; D008787:Metoclopramide