Successful treatment of severe orthostatic hypotension with erythropoietin.
A 71-year-old man, who was diagnosed with familial amyloidosis type I, was admitted for treatment of severe orthostatic hypotension associated with recurrent syncopal attacks. Head-up tilt testing demonstrated severe orthostatic hypotension (114/72 mmHg in the supine position and 62/34 mmHg in the upright position) with syncope or presyncope. Oral midodorine and fludrocortisone therapies failed to prevent his symptoms. After administration of subcutaneous erythropoietin, his blood pressure drop in the upright position was decreased and symptoms disappeared unassociated with improvement of anemia. Although previous reports have shown that the mechanism by which erythropoietin improves orthostatic hypotension is related to improvement in anemia, other mechanisms may also play a role.
Kawakami
Kazunobu
K
Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abe
Haruhiko
H
Harayama
Nobuya
N
Nakashima
Yasuhide
Y
D000368:Aged; D028227:Amyloid Neuropathies, Familial / Q000150:complications; D001794:Blood Pressure / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D011994:Recombinant Proteins; D013575:Syncope / Q000209:etiology; D018667:Tilt-Table Test
D011994:Recombinant Proteins; D004921:Erythropoietin