Recombinant human erythropoietin for a Jehovah's Witness with anemia of thermal injury

We report the use of recombinant human erythropoietin (rh-Ep) as an alternative to transfusion therapy in a burn victim who was a Jehovah's Witness and refused blood transfusion. Despite endogenous elevated erythropoietin levels, the patient was reticulocytopenic and administration of rh-Ep was accompanied by a 10-fold increase in reticulocyte response and a rise in hemoglobin from 7.4 to 10.4 g/dl over a 12-day period. We suggest that the exogenously administered erythropoietin overcame a clinically inadequate endogenous erythropoietin response.