Anti-erythropoietin antibody-mediated pure red cell aplasia in a living donor liver transplant recipient treated for hepatitis C virus.
After liver transplantation, reinfection of the newly engrafted liver with hepatitis C virus is essentially universal in patients who are viremic at the time of transplantation. Treatment with interferon preparations with or without ribavirin is recommended in patients with marked histologic injury; however, hematologic toxicity associated with therapy has been reported, which is usually treated with growth factor support, including erythropoietin analogues. We present the first reported case of anti-erythropoietin antibody-mediated pure red cell aplasia arising in the setting of hepatitis C virus therapy in a patient who underwent living donor liver transplantation.
Schecter
Jordan M
JM
Department of Medicine, Columbia University, College of Physicians and Surgeons, New York, NY, USA.
Mears
J Gregory
JG
Alobeid
Bachir
B
Gaglio
Paul J
PJ
D000740:Anemia / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology; D000906:Antibodies / Q000097:blood; D000998:Antiviral Agents / Q000009:adverse effects*; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000009:adverse effects* / Q000276:immunology; D006084:Graft Rejection / Q000517:prevention & control; D006397:Hematinics / Q000627:therapeutic use; D006526:Hepatitis C / Q000188:drug therapy* / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011092:Polyethylene Glycols; D011241:Prednisone / Q000627:therapeutic use; D011994:Recombinant Proteins; D012010:Red-Cell Aplasia, Pure / Q000150:complications / Q000276:immunology* / Q000503:physiopathology; D012254:Ribavirin / Q000627:therapeutic use; D055502:Secondary Prevention; D016559:Tacrolimus / Q000627:therapeutic use
D000906:Antibodies; D000998:Antiviral Agents; D006397:Hematinics; D007166:Immunosuppressive Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D004921:Erythropoietin; D011092:Polyethylene Glycols; D012254:Ribavirin; D000068817:Epoetin Alfa; C417083:peginterferon alfa-2b; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus