RECOVERY OF PANCREATIC BETA-CELL FUNCTION IN HEMOCHROMATOSIS - COMBINED TREATMENT WITH RECOMBINANT-HUMAN-ERYTHROPOIETIN AND PHLEBOTOMY

A patient with diabetes mellitus caused by secondary hemochromatosis w as treated using recombinant human erythropoietin and phlebotomy. A to tal of 12 g of iron had been infused in the patient because of iron de ficiency anemia. Blood glucose level was 17.3 mmol/L, and hemoglobin A (1c) level was 9.0% at admission. He was treated using phlebotomy (400 mt per week), along with subcutaneous injection of 3,000 U of recombi nant human erythropoietin three times a week. After approximately 100 days, a total of 5,500 mt of blood (2.75 g iron) could be removed. Ser um ferritin level decreased from 10,000 mu g/L to 4,807 mu g/L. Fastin g and maximum serum C-peptide immunoreactivity values during 100-g ora l glucose tolerance tests were improved from 0.14 nmol/L to 0.42 nmol/ L and from 1.84 nmol/L to 2.61 nmol/L, respectively. This case suggest s that pancreatic beta-cell recovers in diabetes caused by hemochromat osis by reducing iron overload during a short period.