Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Iron chelation therapy must be associated with the regular blood transfusions required for thalassaemia and other chronic anemias. We report here a study concerning 4 groups of patients, aged 6 to 28, regularly transfused at Necker Enfants-Malades hospital: a) 20 with thalassaemia major; b) 6 with thalassaemia intermedia; c) 2 with sickle cell disease and d) 2 with Blackfan-Diamond syndrome. The transfusion regimen consisting of monthly or quarterly transfusions varied as a function of the groups. Desferal was used in all patients. The dosage and the route of administration (IV, IM, SC) were adapted to the amount of iron transfused and to the nature of the disease. The serum ferritin level was considered as the indicator of the iron overload. Comparisons were established between the quantities of iron transfused, ferritin levels, and parameters such as dosage, route of administration and compliance to Desferal. During the period of study 3 patients died from cardiac failure due to transfusional hemosiderosis. Endocrine complications (diabetes 2 cases, hypocalcemia 3 cases, hypothyroidism 1 case and delayed puberty 7 cases) were observed. This high incidence of complications induced by post-transfusional iron overload has recently prompted us to improve the quality of chelation therapy through the use of the services of a specialized center where patients as well as their families can be trained more adequately in home care and self-treatment.
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PMID:[Treatment of post-transfusion iron overload by deferoxamine]. 273 4

Acquired hemosiderosis resulting from massive iron deposits in various organs, including heart, liver, and pancreas, may lead to architectural and functional disturbances of these organs. Even though iron overload can occur in nonuremic as well as in uremic individuals, the dialysis patient is at particular risk for developing hemosiderosis. Many dialysis patients receive exogenous iron from either oral iron therapy or blood transfusions. In addition, these patients seem to be at high risk for retaining iron. A diagnosis of excess iron deposition should be considered if the patient has unexplained cardiomyopathy, hepatic cirrhosis, proximal myopathy, diabetes mellitus, arthropathy, or immune dysfunction such as listeriosis. Several techniques are available for determining iron overload. Diagnostic tests include measuring serum ferritin levels, staining bone marrow preparations for excess iron, measuring tissue hemosiderin concentrations, magnetic resonance imaging, and the deferoxamine (DFO; Desferal) "challenge test." The simplest treatment for iron overload in nonuremic patients is removal of iron by venesection. However, in patients in whom venesection is not feasible, the chelating agent DFO can effectively remove excess iron. In the dialysis patient, DFO therapy can be combined with either dialysis or hemoperfusion to remove the iron-DFO complex that would otherwise be removed by the kidney. DFO therapy in the nondialyzed individual has proven to be successful, but before treatment, the benefits of the treatment must be weighed against possible adverse side effects such as cataracts, changes in color vision, and anaphylaxis. In the dialysis patient, indications for iron removal are less clearly defined.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of iron overload in dialysis patients. 329 89

Thalassaemic patients with haemocromatosis often present with metabolic disturbances such as diabetes mellitus. A group of adult thalassaemic patients who received intensive oral and subcutaneous chelation therapy (Defferiprone/Ferriprox and Desferioxamine/Desferal) for a period of 24-36 months was studied for the presence of glucose metabolism disturbances (GMD). Investigation of the prevalence of diabetes mellitus (DM) and impaired glucose tolerance (IGT) was carried out by yearly oral glucose tolerance tests (OGTT). Results showed that GMD (DM and IGT) improved in 1/3 of the patients after the intensive combined chelation treatment, a finding that we attributed to a reduction in liver iron deposits. Although this study is still in progress we believe that intensive combined chelation therapy may have a positive effect on glucose metabolism.
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PMID:Glucose metabolism disorders improvement in patients with thalassaemia major after 24-36 months of intensive chelation therapy. 1646 11

Deferoxamine mesylate (Desferal) is a chelating agent used in hemosiderosis and aluminium overload consecutive to renal dialysis. This drug is the most efficacious for treating iron overload but is associated with ocular toxicity: dose and duration related symptomatic optic neuropathy on the one hand, reversible if treatment stopped, and acute retinal involvement followed by irreversible paucisymptomatic pigmentary changes on the other hand. Toxic risk factors are intravenous mode of administration, high doses, small iron or aluminium overload, diabetes and young age. Hence, dosis should be adapted to the amount of overload and ophthalmological follow-up should be instaured. Indeed, if treatment is stopped at the beginning of the toxic effect, ocular involvement is reversible. The baseline ophthalmological examination should include visual acuity measurement, color vision, visual fields, slit lamp and fundus. In case of risk factors, electrophysiology and fluoangiography should be added.
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PMID:[Retinal pigment epithelium--desferal]. 1771 28