Incidence and Clinical Characteristics of Diabetes Mellitus in Aplastic Anemia Patients Treated with Multiple Transfusions.

Park,  So Young; Cha,  Eun Young; Jung,  Min Ho; Chung,  Nak Gyun; Cho,  Bin; Kim,  Hak Ki; Lee,  Byung Churl

Ann Pediatr Endocrinol Metab > Volume 11(1); 2006 > Article

Original Article

Journal of Korean Society of Pediatric Endocrinology 2006;11(1): 70-75.

Incidence and Clinical Characteristics of Diabetes Mellitus in Aplastic Anemia Patients Treated with Multiple Transfusions.

So Young Park, Eun Young Cha, Min Ho Jung, Nak Gyun Chung, Bin Cho, Hak Ki Kim, Byung Churl Lee

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. jmhpe@catholic.ac.kr

Abstract

PURPOSE
We investigated the epidemiological and clinical characteristics of diabetes mellitus developed in aplastic anemia patients who have had many blood transfusions. METHODS: We retrospectively reviewed medical records of 170 patients with aplastic anemia who were diagnosed before 15 years of age in Department of Pediatrics, The Catholic University of Korea from 1987 to 2001. We obtained their medical history, family history of diabetes mellitus, clinical onset of diabetes mellitus and the successive history, and coexistence of other disorders.
RESULTS
Diabetes mellitus was diagnosed in 8 of 107 patients (7.5%) with severe aplastic anemia in childhood. The mean age of diagnosis of diabetes mellitus was 18.5+/-5.2 years, and the mean duration from the start of blood transfusion to the diagnosis of diabetes mellitus was 7.7+/-2.9 years. Duration of multiple blood transfusions was a major risk factor for the development of diabetes mellitus in severe aplastic anemia patients. There was a wide range of symptoms at clinical onset of diabetes mellitus from asymptomatic hyperglycemia to diabetic ketoacidosis. Incidence of other complications, such as hepatic impairment (88%) and cardiac dysfunction (75%), was high in patients who developed diabetes mellitus.
CONCLUSION
Severe aplastic anemia patients treated with prolonged, multiple transfusions have a significant risk of developing insulin-deficient diabetes mellitus. These patients are at risk for other complications, such as hepatic, cardiac, or thyroid disorders. Early prevention of iron overload and screening for transfusion-related complications are very important in these patients.

Keywords: Diabetes mellitus;Aplastic anemia;Iron overload;Transfusion