Acquired Pure Red Cell Aplasia due to Anti-Erythropoietin Antibodies in a Patient Undergoing Hemodialysis.
- Author:
Me Ae KIM
1
;
Se Ho CHANG
;
Kook Young MAENG
Author Information
- Publication Type:Case Report
- Keywords: Hemodialysis; Anti-erythropoietin antibody (Anti-EPO Ab); Pure red cell aplasia (PRCA)
- MeSH: Anemia; Antibodies*; Bone Marrow Examination; Erythrocyte Transfusion; Erythropoietin; Humans; Middle Aged; Red-Cell Aplasia, Pure*; Renal Artery Obstruction; Renal Dialysis*; Reticulocyte Count
- From:Korean Journal of Hematology 2005;40(1):45-48
- CountryRepublic of Korea
- Language:English
- Abstract: A 63-year-old man was placed on hemodialysis for the end-stage of renal disease secondary to renal artery stenosis. He was also regularly given epoetin, subcutaneously, for anemia associated with his renal disease. Rapidly progressing erythropoietin (EPO) resistant anemia and reticulocytopenia developed after 1 year of hemodialysis. The patient required frequent red blood cell transfusions. The bone marrow examination demonstrated selective erythroid hypoplasia. A detailed search for the cause of the erythroblastopenia revealed nothing, with the exception of anti-EPO antibodies (Ab). Pure red cell aplasia (PRCA) was suspected due to the anti-EPO Ab. With the immunosuppressive agent and change to the epoetin-therapy, the patient recovered his hemoglobin and reticulocyte counts. Particular attention should be paid for the possibility of PRCA due to anti-EPO Ab in patients undergoing rHuEPO therapy, with an unexplained recombinant human erythropoietin (rHuEPO) resistant anemia, especially via the subcutaneous route.
