Acute cardiac decompensation in a patient with beta‐thalassemia and diabetes mellitus following cessation of chelation therapy

Abstract

Key Clinical MessagePatients with higher liver iron stores are likely to have a worse cardiac outcome following noncompliance with chelation. Cardiovascular magnetic resonance identifies myocardial siderosis allowing optimization of iron chelation regimes. Diabetes puts thalassemic patients at increased risk of myocardial fibrosis. Dual chelation therapy with deferoxamine and deferiprone offers improved cardiac outcomes.

Drug interactions of meglitinide antidiabetics involving CYP enzymes and OATP1B1 transporter

“…[92][93][94] The diabetic patients with β thalassemia may be prescribed deferasirox to treat iron overload. 95 Deferasirox is a weak inhibitor of both CYP3A4 and CYP2C8 enzymes, 96 which are involved in the metabolism of repaglinide. Concomitant use of deferasirox and repaglinide warrants careful monitoring of glucose levels.…”

“…92–94 The diabetic patients with β thalassemia may be prescribed deferasirox to treat iron overload. 95…”