Effectiveness of Erythrocytapheresis in Idiopathic Hemochromatosis. Report of 14 Cases

Thirteen men and one woman (mean age 48.8 yr ± 6.9, range 36–63) with idiopathic hemochromatosis were treated by erythrocytapheresis. Iron depletion followed 9–60 months treatment (median 24), with 21–203 erythrocytaphereses (mean 93 ± 61) and total iron removal of 4.2–40. 6 g (mean 19 ± 11.9). Trasferrin saturation decreased from 90 ± 8.7% to 17 ± 10.6% and serum ferritin from 3164 μg/L ± 1488 to 60.5 μg/L ± 77.5, and liver iron content normalized in all cases. Initial serum ferritin in the patients who were iron-depleted at 18 months (50%, cumulative percentage) was significantly lower than in those still iron loaded at that time (2280 μg/L ± 940 vs 4049 μg/L ± 1444, p<0.02). Clinical improvement was noted in all cases with about a 30% decrease in insulin requirement in most diabetics. Thus erythrocytapheresis appears to be effettive and safe in obtaining iron depletion in idiopathic hemochromatosis.