Successful treatment of Diamond-Blackfan anemia with metoclopramide.
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.
Akiyama
Masaharu
M
Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan. makiyama@jikei.ac.jp
Yanagisawa
Takaaki
T
Yuza
Yuki
Y
Yokoi
Kentaro
K
Ariga
Masamichi
M
Fujisawa
Kohji
K
Hoshi
Yasutaka
Y
Eto
Yoshikatsu
Y
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
D018492:Dopamine Antagonists; D006454:Hemoglobins; D011388:Prolactin; D008787:Metoclopramide