title: An unusual etiology of erythropoietin resistance: hyperthyroidism.
abstract: Many possible causes of resistance to human recombinant erythropoietin (rh-EPO) have been reported in patients with renal failure. This case presents an unusual cause of erythropoietin-resistant anemia in a patient with chronic renal failure. A 61-year-old male patient who was on chronic hemodialysis program due to diabetic nephropathy for seven months developed erythropoietin resistant anemia. No iron deficiency was revealed by laboratory data, no megaloblastic anemia were found by biochemical investigation, and no inflammatory states including infection or neoplastic diseases were disclosed by abdominal ultrasonography, chest X-ray, bone marrow aspiration and biopsy, or other methods (normal C-reactive protein levels). This hemodialysis patient had epoetin-resistant anemia with primary autoimmune hyperthyroidism. The anti-thyroid therapy was effective not only against the hyperthyroidism but also against his epoetin resistant anemia.
authors.affiliation: Department of Nephrology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey. kkaynar@yahoo.com
authors.forename: Kubra
authors.initials: K
authors.lastname: Kaynar
authors.forename: Gulsum
authors.initials: G
authors.lastname: Ozkan
authors.forename: Cihangir
authors.initials: C
authors.lastname: Erem
authors.forename: Semih
authors.initials: S
authors.lastname: Gul
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Bircan
authors.initials: B
authors.lastname: Sonmez
authors.forename: Feyyaz
authors.initials: F
authors.lastname: Ozdemir
authors.forename: Sukru
authors.initials: S
authors.lastname: Ulusoy
mesh_terms: D000740:Anemia / Q000188:drug therapy* / Q000209:etiology; D013956:Antithyroid Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000150:complications*; D004351:Drug Resistance; D004921:Erythropoietin / Q000627:therapeutic use*; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications* / Q000188:drug therapy; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis
chemical_list: D013956:Antithyroid Agents; D011994:Recombinant Proteins; D004921:Erythropoietin; D008713:Methimazole