Successful re-introduction of recombinant human erythropoietin following antibody induced pure red cell aplasia. |
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| Authors: | Shaun A Summers Ante Matijevic Mike K Almond |
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| Affiliation: | Renal Medicine, Southend General Hospital, Westcliff-on-Sea, Essex, UK. shaunsummers@hotmail.com |
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| Abstract: | | Introduction | Reports of pure red cell aplasia (PRCA) secondary to recombinanthuman erythropoietin (rHuEPO), predominantly following the administrationof subcutaneous (s.c.) epoetin alfa, have increased dramaticallyover the past 3 years. Treatment with immunosuppressive agentshas been partially successful in some patients, rendering themtransfusion independent. To date there are no reports describingthe re-introduction of rHuEPO. We discuss the case of an 81-year-old man on maintenance haemodialysiswho developed PRCA, with positive anti-EPO antibodies (Abs)whilst receiving s.c. epoetin alfa. The epoetin alfa was stopped,cyclosporine (CyA) started and regular transfusions prescribedwhen symptomatically anaemic. After receiving CyA therapy for4 months he became anti-EPO Ab negative. One year after startingCyA he was re-challenged with rHuEPO-intravenous (i.v.) darbepoetinalfa. Re-introduction has been
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| Keywords: | cyclosporine haemoglobin pure red cell aplasia recombinant human erythropoietin |
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