Leeching as a substitute for phlebotomy
Phlebotomy is a therapeutic technique that is commonly used in
haemochromatosis and polycythemia vera. In some cases, phlebotomy
cannot be performed because of intolerance or technical problems. We
present an example of successful phlebotomy in hereditary
haemochromatosis with the use of leeches. A 61-year-old female with a
homozygous HFE C282Y mutation had previously needed venesection every
3 months to maintain a ferritin level below 100 ug/l. Because of
severe vasovagal reactions during venesection, she switched to therapy
with leeches. During a typical bloodsucking procedure of one hour's
duration eight leeches increased their body weight from 3 to 35 g.
After the leeches had dropped off, bleeding continued for several
hours . The wound dressing weighed 440 g more after therapy than
before. This added up to about 475 g loss of blood per session, and
was comparable to a typical venesection. Five leeching procedures
reduced the ferritin level from 1200 ug/l to the very low level of 17
ug/l because of over enthusiasm. We thank Mrs. L. Schumacher for her
idea and for the photographs and also Mrs. S. Tolusso for performing
the leeching procedure.
Michael Nagler
Walter A. Wuillemin
Division of Haematology and Central Haematology Laboratory, Luzerner
Kantonsspital , Lucerne , Switzerland.
E-mail: walter.weille...@ksl.ch
http://tinyurl.com/3v9bulw