4-Conclusion and Results:
Owing to ongoing fever, neutrophilia and elevated CRP, treatment with
antibiotics was indicated. Patients were prescribed ciprofloxacin 500 mg
orally twice daily for the treatment of non-severe Yersinia
enterocolitis for a total of 5 days.
All three patients had clinical and biochemical improvement following
treatment with antibiotics and their symptoms had completely abated
thereafter. No side effects were reported during the course of
antibiotics.
All three patients were candidates for therapeutic phlebotomy as they
were not anemic with a target serum ferritin between 50 and 100 ng/mL.
They were also educated about hemochromatosis.
Phlebotomy was subsequently initiated for the management of HH with
periodic monitoring of hemoglobin (Hb) and ferritin levels.
Patients were counseled regarding risk reduction whereby they were
advised to avoid excess alcohol, raw-seafood and contact of open wounds
with seawater. They were also counseled about the appropriateness ofHFE testing in their first-degree relatives.
Patients were subsequently scheduled for ultrasound of the abdomen every
6 months to perform surveillance for HCC because hepatic iron overload
is present in all three patients. Table 1 summarizes the three case
reports in terms of patients’ characteristics, biochemical and genetic
workup and treatment regimens, respectively.