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Neonatal diabetes mellitus: remission induced by novel therapy
  1. Pradip Dalwadi,
  2. Ameya S Joshi,
  3. Darshana Sudip Thakur and
  4. Nikhil M Bhagwat
  1. Endocrinology, Topiwala National Medical College and BYL Nair Charitable Hospital, Mumbai, Maharashtra, India
  1. Correspondence to Dr Nikhil M Bhagwat, bhagwatnik{at}


A female child with deafness was diagnosed to have neonatal diabetes mellitus at the age of 6 months, on routine evaluation prior to cochlear implant surgery. She presented to us at 11 months of age with diabetic ketoacidosis due to an intercurrent febrile illness. Her haematological parameters showed megaloblastic anaemia and thrombocytopenia. Therefore a possibility of Thiamine Responsive Megaloblastic Anaemia (TRMA) syndrome was considered. She was empirically treated with parenteral thiamine hydrochloride (Hcl). Subsequently, due to the unavailability of pharmacological preparation of oral thiamine Hcl in a recommended dose she was treated with benfotiamine. She had a sustained improvement in all her haematological parameters on oral benfotiamine. The insulin requirement progressively reduced and she is currently in remission for last 2 years. The genetic analysis confirmed the diagnosis of TRMA syndrome. Thus benfotiamine can be considered a new treatment option in management of TRMA syndrome.

  • endocrine system
  • paediatrics (drugs and medicines)
  • diabetes
  • haematology (incl blood transfusion)
  • neonatal and paediatric intensive care
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  • Contributors PD and ASJ have conceptualised and designed the case report. DST and PD have contributed to acquisition and interpretation of data. DST, ASJ and NMB drafted the article. NMB finalised the article by revising and editing it critically.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.

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