Intern Med. 2007;46(10):637-642. Epub 2007 May 24.Effects of Dietary
Iron Reduction Versus Phlebotomy in Patients with Chronic Hepatitis C:
Results from a Randomized, Controlled Trial on 40 Japanese
Patients.Sumida Y, Kanemasa K, [censored] K, Yoshida N, Sakai K.
Department of Gastroenterology and Hepatology, Nara City Hospital.
Background and Aim Iron may play an important role in the pathogenesis
of hepatitis C. We conducted this randomized, controlled trial
comparing phlebotomy with dietary iron reduction. Methods Forty
patients with chronic hepatitis C showing serum ferritin levels of
over 150 ng/ml were randomized to either group A (low-iron diet for
six months) or group B (phlebotomy biweekly). Phlebotomy was continued
until serum ferritin had reached 20 ng/ml or less. Results At
enrollment the clinical characteristics of patients in the two groups
were similar. Serum ALT levels were significantly reduced in both
groups, but the percent change in alanine aminotransferase (ALT) was
larger in group B (median, -47.1 [range, -69.1 to -16.7] %) than in
group A (-24.2 [-72.6 to 15.9] %, p<0.001). In group A subjects, no
correlation was detected between percent change in ALT and clinical
parameters. In group B subjects, the baseline ALT activity was
significantly correlated with percent change in ALT (p<0.05), but iron-
related parameters were not correlated. Conclusion The efficacy of
phlebotomy is superior to that of dietary iron reduction in chronic
hepatitis C. Serum levels of transaminase activities were a better
indicator for phlebotomy than conventional indices of iron overload.
PMID: 17527035 [PubMed - as supplied by publisher]
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