Reversal of cardiac complications by deferiprone and deferoxamine combination therapy in a patient affected by a severe type of juvenile hemochromatosis (JH)

Blood. 2007 Jan 1;109(1):362-4. doi: 10.1182/blood-2006-04-016949. Epub 2006 Sep 7.

Abstract

Juvenile hemochromatosis (JH) is a rare autosomal recessive disorder of iron metabolism, genetically heterogeneous. In JH, symptomatic organ involvement occurs as early as the second decade of life. Heart failure and/or arrhythmias are the most frequent causes of death. Phlebotomy is the safest, most effective, and most economic therapeutic approach in hemochromatosis patients but is not indicated during the treatment of severe congestive heart failure with unstable hemodynamic status. The treatment of iron overload in these prohibitive clinical situations has to be carried out using iron chelators. We report a case of heart failure in the setting of unrecognized juvenile hemochromatosis successfully treated by the simultaneous administration of deferoxamine and deferiprone. To our knowledge, this is the first patient affected by JH treated with combined chelation regimen.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amino Acid Substitution
  • Antimicrobial Cationic Peptides / genetics
  • Atrial Fibrillation / etiology
  • Chelation Therapy / methods*
  • DNA Mutational Analysis
  • Deferiprone
  • Deferoxamine / administration & dosage
  • Deferoxamine / therapeutic use*
  • Drug Therapy, Combination
  • Heart Failure / drug therapy
  • Heart Failure / etiology*
  • Hemochromatosis / complications
  • Hemochromatosis / drug therapy*
  • Hepcidins
  • Humans
  • Infertility, Male / etiology
  • Iron Chelating Agents / administration & dosage
  • Iron Chelating Agents / therapeutic use*
  • Male
  • Mutation, Missense
  • Pedigree
  • Point Mutation
  • Pyridones / administration & dosage
  • Pyridones / therapeutic use*
  • Remission Induction

Substances

  • Antimicrobial Cationic Peptides
  • Hepcidins
  • Iron Chelating Agents
  • Pyridones
  • Deferiprone
  • Deferoxamine