OBJECTIVE- To identify and treat a unique form of anemia in patients w
ith long-term IDDM. RESEARCH DESIGN AND METHODS- Patients with IDDM, u
nexplained symptomatic anemia, and serum creatinine levels of <177 mu
mol/l (2.0 mg/dl) were treated with epoetin alfa (Procrit, Ortho Biote
ch, Raritan, NJ), 50 U/kg three times weekly, subcutaneously, to reach
a target hematocrit of 38-40%. Baseline serum erythropoietin titers w
ere measured before drug therapy. RESULTS- Six patients were treated w
ith epoetin alfa. Median age of the group was 74 years, with IDDM bein
g diagnosed for a median of >20 years. All patients had symptoms of an
emia with a median hematocrit of 28.9% (range 27-31). Compared with ir
on deficiency control patients, the group had a limited erythropoietin
(EPO) response to the degree of anemia. All patients showed increases
in hematocrit, median peak of 40.9%, with median time-to-peak respons
e of 12 weeks. Baseline symptoms of anemia resolved in all patients. N
o adverse effects were noted during the treatment period. CONCLUSIONS-
There is a unique form of anemia in patients with long-term IDDM and
clinically normal renal function who respond to low-dose epoetin alfa
therapy The rapid response to therapy and depressed baseline erythropo
ietin titers suggest the anemia is due to a lack of endogenous EPO rel
ease.