Antiepoetin antibody-related pure red cell aplasia: successful remission with cessation of recombinant erythropoietin alone.
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.
Katagiri
Daisuke
D
Department of Nephrology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-0051, Japan.
Shibata
Maki
M
Katsuki
Takashi
T
Masumoto
Shoichi
S
Katsuma
Ai
A
Minami
Eri
E
Hoshino
Taro
T
Inoue
Tsuyoshi
T
Tada
Manami
M
Hinoshita
Fumihiko
F
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
D057134:Antibodies, Neutralizing; D006397:Hematinics; D011994:Recombinant Proteins; C103998:epoetin beta; D004921:Erythropoietin; D000068817:Epoetin Alfa