Patient with Secondary Amyloidosis Due to Crohn's Disease on Hemodialysis Effectively Treated with Ferric Carboxymaltose Injections: A Case Report and Literature Review.

Abstract

Background: Almost all patients undergoing dialysis develop renal anemia and receive medicines such as erythropoietin and iron preparations. However, the conventional intravenous treatment with saccharated ferric oxide (SFO) is insufficient for these patients when they have incurable and persistent iron deficiency anemia due to secondary amyloidosis. Therefore, we administered 500 mg of ferric carboxymaltose (FCM) to such a patient with Crohn's disease. Case presentation: A 56-year-old man on maintenance hemodialysis had secondary amyloidosis due to Crohn's disease. Additionally, he was anemic and received 40 mg of SFO weekly; however, his hemoglobin (Hb) level remained low at 7 g/dL. Therefore, 500 mg of FCM was administered bimonthly from the first to the fourth dose, and the Hb level temporarily increased compared to that after the previous SFO administration. Since bimonthly administration did not adequately maintain the Hb level, FCM was administered monthly from the 5th to 12th dose, which stabilized the Hb level at 10-12 g/dL. No side effects, such as hypophosphatemia, were observed. Conclusions: A single dose of 500 mg FCM administered once every 1-2 months stabilizes the Hb level and contributes to efficient iron utilization in patients with incurable anemia undergoing hemodialysis.