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- Title
Megaloblastic anemia-related iron overload and erythroid regulators: a case report.
- Authors
Vallet, Nicolas; Delaye, Jean-Baptiste; Ropert, Martine; Foucault, Amélie; Ravalet, Noémie; Deriaz, Sophie; Chalopin, Thomas; Blasco, Hélène; Maillot, François; Hérault, Olivier; Gyan, Emmanuel
- Abstract
<bold>Background: </bold>In ineffective erythropoiesis, hepcidin synthesis is suppressed by erythroid regulators, namely erythroferrone and growth differentiation factor-15. For the first time, the hypothesis that iron overload in megaloblastic anemia may be related to ineffective erythropoiesis is explored by describing the kinetics of hepcidin, erythroferrone, and growth differentiation factor-15 levels in a patient diagnosed with megaloblastic anemia associated with iron overload.<bold>Case Presentation: </bold>An 81-year-old Caucasian male was admitted for fatigue. He had type-2 diabetes previously treated with metformin, ischemic cardiac insufficiency, and stage-3 chronic kidney disease. Vitiligo was observed on both hands. Biological tests revealed normocytic non-regenerative anemia associated with hemolysis, thrombocytopenia, and elevated sideremia, ferritin, and transferrin saturation levels. Megaloblastic anemia was confirmed with undetectable blood vitamin B12 and typical cytological findings like hyper-segmented neutrophils in blood and megaloblasts in bone marrow. The patient received vitamin B12 supplementation. At 3 months, biological parameters reached normal values. Hepcidin kinetics from diagnosis to 3 months inversely correlated with those of erythroferrone and growth differentiation factor-15.<bold>Conclusions: </bold>This case suggests that iron-overload mechanisms of dyserythropoietic anemias may apply to megaloblastic anemias.
- Subjects
IRON overload; TYPE 2 diabetes; VITAMIN B12; HEART failure; CHRONIC kidney failure; DIETARY supplements; MACROCYTIC anemia; IRON; IRON in the body; ERYTHROPOIESIS; ANEMIA
- Publication
Journal of Medical Case Reports, 2021, Vol 15, Issue 1, p1
- ISSN
1752-1947
- Publication type
journal article
- DOI
10.1186/s13256-021-03065-0