ANEMIA DUE TO REDUCED SERUM ERYTHROPOIETIN CONCENTRATION IN NON-UREMIC DIABETIC-PATIENTS

We encountered two patients with non-insulin-dependent diabetes mellit us (DM) who developed normocytic normochromic anemia, Routine hematolo gical examinations revealed no specific causes except for the reduced serum levels of erythropoietin. Since their renal functions were prese rved, the anemias may not have been due to chronic renal failure. Trea tment with human recombinant erythropoietin (rHuEPO) improved anemia, ascribing the cause of anemia to low levels of erythropoietin in these patients. Underlying common clinical features of the two patients wer e longstanding poorly controlled diabetes mellitus accompanied with ad vanced neuropathy. Since erythropoietin production is regulated in par t by autonomic nervous system, the results suggest that erythropoietin production could be prematurely impaired in patients with severe diab etic autonomic neuropathy.