title: Immunohistochemical findings in the pancreatic islets of a patient with transfusional iron overload and diabetes: case report.
abstract: Excessive iron storage sometimes causes diabetes in patients with hemochromatosis, a disease caused by iron overloading. We performed an immunohistochemical analysis to study an autopsy case of aplastic anemia and diabetic hemochromatosis caused by frequent blood transfusions, and extensive hemosiderin deposition was observed in the liver and pancreas. The pancreatic islets of the patient and a control subject were stained to detect glucagon, insulin, and proinsulin. Significantly lower levels of immunoreactivity with both insulin antibodies and proinsulin antibodies, but not with glucagon antibodies, was observed in the islet cells in the patient's tissue than in the islet cells of the control. Hemosiderin deposition in the islets is known to be exclusively distributed in the β-cells, thus, selective iron-induced damage to the β-cells may have affected insulin synthesis and secretion and led to glucose intolerance in the patient.
authors.affiliation: Department of Diabetes and Metabolic Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Miyako
authors.initials: M
authors.lastname: Kishimoto
authors.forename: Hisako
authors.initials: H
authors.lastname: Endo
authors.forename: Shotaro
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Miwa
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D006432:Hemochromatosis / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D006485:Hemosiderin / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D019190:Iron Overload / Q000209:etiology / Q000378:metabolism* / Q000473:pathology*; D007515:Islets of Langerhans / Q000378:metabolism* / Q000473:pathology*; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008297:Male; D065227:Transfusion Reaction
chemical_list: D006485:Hemosiderin