Brigant Fanny, Hautefeuille Vincent, Dadban Ali, Lok Catherine, Nguyen-Khac Eric, Chaby Guillaume
CH St Quentin, 1 avenue Michel de l'hôspital.
Dermatol Online J. 2015 Sep 17;21(9):13030/qt4qg8m234.
This paper describes a case of pruritus caused by dysmetabolic hyperferritinemia treated by multiple phlebotomies. A 63-year-old man was followed for generalized pruritus, which was resistant to the usual treatments. He presented with metabolic syndrome. Physical examination showed only excoriations and lichenification on the skin. The serum ferritin was high at 1043 ng/ml, with transferrin saturation at 67%. The other biological investigations and genetic tests for hemochromatosis were negative. In spite of the dietary measures, the ferritin level was still high (853 ng/ml). Magnetic resonance imaging confirmed hepatic iron overload.The association of hyperferritinemia, hepatic iron overload, and metabolic syndrome led to the diagnosis of dysmetabolic hyperferritinemia. Phlebotomies are an unusual treatment, but because the pruritus and hyperferritinemia were still present, phlebotomy was initiated. After 19 months, the patient reported improvement of his pruritus and normalization of ferritin levels.
本文描述了一例通过多次放血治疗的代谢异常性高铁蛋白血症引起的瘙痒症。一名63岁男性因全身性瘙痒接受随访，该瘙痒对常规治疗无效。他患有代谢综合征。体格检查仅发现皮肤有抓痕和苔藓化。血清铁蛋白升高至1043 ng/ml，转铁蛋白饱和度为67%。其他关于血色素沉着症的生物学检查和基因检测均为阴性。尽管采取了饮食措施，铁蛋白水平仍很高（853 ng/ml）。磁共振成像证实肝脏存在铁过载。高铁蛋白血症、肝脏铁过载和代谢综合征的关联导致了代谢异常性高铁蛋白血症的诊断。放血是一种不常见的治疗方法，但由于瘙痒和高铁蛋白血症仍然存在，于是开始进行放血治疗。19个月后，患者报告瘙痒症状有所改善，铁蛋白水平恢复正常。
