Aceruloplasminemia with Abnormal Compound Heterozygous Mutations Developed Neurological Dysfunction during Phlebotomy Therapy

Intern Med. 2018 Sep 15;57(18):2713-2718. doi: 10.2169/internalmedicine.9855-17. Epub 2018 Apr 27.

Abstract

Aceruloplasminemia is an autosomal recessive inherited disorder caused by ceruloplasmin gene mutations. The loss of ferroxidase activity of ceruloplasmin due to gene mutations causes a disturbance in cellular iron transport. We herein describe a patient with aceruloplasminemia, who presented with diabetes mellitus that was treated by insulin injections, liver hemosiderosis treated by phlebotomy therapy, and neurological impairment. A genetic analysis of the ceruloplasmin gene revealed novel compound heterozygous mutations of c.1286_1290insTATAC in exon 7 and c.2185delC in exon 12. This abnormal compound heterozygote had typical clinical features similar to those observed in aceruloplasminemia patients with other gene mutations.

Keywords: aceruloplasminemia; anemia; ceruloplasmin gene; diabetes mellitus; liver hemosiderosis; phlebotomy therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ceruloplasmin / deficiency*
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy
  • Female
  • Hemosiderosis / complications*
  • Hemosiderosis / therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • INDEL Mutation
  • Insulin / therapeutic use
  • Iron Metabolism Disorders / complications*
  • Neurodegenerative Diseases / complications*
  • Phlebotomy / adverse effects*

Substances

  • Hypoglycemic Agents
  • Insulin
  • Ceruloplasmin

Supplementary concepts

  • Familial apoceruloplasmin deficiency