title: Antiepoetin antibody-related pure red cell aplasia: successful remission with cessation of recombinant erythropoietin alone.
abstract: An elderly patient with pure red cell aplasia (PRCA) with antierythropoietin (anti-EPO) antibodies is described. PRCA due to alloimmunization is a rare and severe complication of recombinant human erythropoietin (rHu-EPO) therapy. Most reported patients with PRCA were cured primarily by immunosuppressive drug therapy. The patient in this case, however, did not want to receive any immunosuppressive drugs. Therefore, rHu-EPO injection was simply discontinued, the severe anemia gradually improved, and the hemoglobin approached normal range. This case is very rare and significant in that there have been few such elderly patients with rHu-EPO-induced PRCA in whom PRCA remission was achieved, with decreasing antibody titers, after cessation of rHu-EPO alone. Further cases are needed to assess how PRCA should be treated in patients with anti-EPO antibodies.
authors.affiliation: Department of Nephrology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-0051, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Katagiri
authors.forename: Maki
authors.initials: M
authors.lastname: Shibata
authors.forename: Takashi
authors.initials: T
authors.lastname: Katsuki
authors.forename: Shoichi
authors.initials: S
authors.lastname: Masumoto
authors.forename: Ai
authors.initials: A
authors.lastname: Katsuma
authors.forename: Eri
authors.initials: E
authors.lastname: Minami
authors.forename: Taro
authors.initials: T
authors.lastname: Hoshino
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Inoue
authors.forename: Manami
authors.initials: M
authors.lastname: Tada
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hinoshita
mesh_terms: D000369:Aged, 80 and over; D057134:Antibodies, Neutralizing / Q000097:blood / Q000276:immunology*; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000009:adverse effects* / Q000276:immunology* / Q000627:therapeutic use; D006397:Hematinics / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy; D011994:Recombinant Proteins; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000139:chemically induced / Q000276:immunology
chemical_list: D057134:Antibodies, Neutralizing; D006397:Hematinics; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068817:Epoetin Alfa