TY - JOUR
T1 - Response of Diamond-Blackfan anemia to metoclopramide
T2 - Evidence for a role for prolactin in erythropoiesis
AU - Abkowitz, Janis L.
AU - Schaison, Gerard
AU - Boulad, Farid
AU - Brown, Deborah L.
AU - Buchanan, George R.
AU - Johnson, Christine A.
AU - Murray, Jeffrey C.
AU - Sabo, Kathleen M.
PY - 2002/10/15
Y1 - 2002/10/15
N2 - A 47-year-old woman with severe macrocytic anemia markedly improved during the second and third trimesters of 3 pregnancies and when breast-feeding her 2 children. Because the serum prolactin level is elevated at these times, we later treated her with metoclopramide (10 mg orally 3 times daily), a medication known to induce prolactin release. Her serum prolactin levels increased from 7 to 133 ng/mL (normal < 20 ng/mL) and hematocrit from 17% to 22% to 35%. With continued therapy (now 10 mg orally daily), her hematocrit has ranged from 30% to 40% for 6 years, although the macrocytosis persists (mean corpuscular volume, 100-112 fL). On the basis of this observation, a pilot study was undertaken of metoclopramide therapy in patients with Diamond-Blackfan anemia who were refractory to low doses of corticosteroids. Fifteen patients were enrolled and 9 completed the planned 16 weeks of therapy. Three individuals responded, suggesting that this therapeutic approach may benefit others. As with the index case, the anemia did not improve until 12 to 15 weeks of therapy had been completed.
AB - A 47-year-old woman with severe macrocytic anemia markedly improved during the second and third trimesters of 3 pregnancies and when breast-feeding her 2 children. Because the serum prolactin level is elevated at these times, we later treated her with metoclopramide (10 mg orally 3 times daily), a medication known to induce prolactin release. Her serum prolactin levels increased from 7 to 133 ng/mL (normal < 20 ng/mL) and hematocrit from 17% to 22% to 35%. With continued therapy (now 10 mg orally daily), her hematocrit has ranged from 30% to 40% for 6 years, although the macrocytosis persists (mean corpuscular volume, 100-112 fL). On the basis of this observation, a pilot study was undertaken of metoclopramide therapy in patients with Diamond-Blackfan anemia who were refractory to low doses of corticosteroids. Fifteen patients were enrolled and 9 completed the planned 16 weeks of therapy. Three individuals responded, suggesting that this therapeutic approach may benefit others. As with the index case, the anemia did not improve until 12 to 15 weeks of therapy had been completed.
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U2 - 10.1182/blood.V100.8.2687
DO - 10.1182/blood.V100.8.2687
M3 - Article
C2 - 12351372
AN - SCOPUS:0037108110
SN - 0006-4971
VL - 100
SP - 2687
EP - 2691
JO - Blood
JF - Blood
IS - 8
ER -