Erythropoietin-induced, antibody-mediated pure red cell aplasia.
Pure red cell aplasia (PRCA) is a rare haematological condition that is characterized by severe aregenerative anaemia due to an almost complete cessation of red blood cell production. While antibody-mediated PRCA was extremely rare before 1998, the incidence of this disorder increased sharply after 1998 in patients receiving subcutaneous epoetin alfa produced by Ortho-Biotech and marketed outside the USA. The diagnosis of antibody-mediated PRCA relies mostly on the results of bone marrow biopsy or aspirate, which shows an absence of erythroid precursors and/or red cell maturation arrest while counts of white cell and platelet precursors are normal, and on the identification of circulating anti-erythropoietin antibodies. Retrospective analysis of PRCA cases has shown that immunosuppressive therapy can induce a disappearance of anti-erythropoietin antibodies in most patients. Eur J Clin Invest 2005; 35 (Suppl. 3): 95-99.
Rossert
Jérôme
J
Hôpital Européen Georges Pompidou, Paris, France. jerome.rossert@egp.aphp.fr
D000906:Antibodies / Q000276:immunology*; D001772:Blood Cell Count; D000068817:Epoetin Alfa; D004912:Erythrocytes / Q000276:immunology; D004921:Erythropoietin / Q000009:adverse effects / Q000276:immunology*; D006397:Hematinics / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D011994:Recombinant Proteins; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology*
D000906:Antibodies; D006397:Hematinics; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa