title: Postoperative high-dose intravenous iron sucrose with low dose erythropoietin therapy after total hip replacement.
abstract: Erythropoietin combined with parenteral iron sucrose therapy is an alternative to blood transfusion in anemic patients. It was shown to be effective in surgical patients in several previous studies when used in conjunction with other methods. However, there are no guidelines about safety limits in dosage amounts or intervals. In this study, we report a case of significant postoperative hemorrhage managed with high dose parenteral iron sucrose, low dose erythropoietin, vitamin B(12), vitamin C, and folic acid. An 80-year-old female patient presented for severe anemia after a total hip arthroplasty and refused an allogenic blood transfusion as treatment. The preoperative hemoglobin of 12.2 g/dL decreased to 5.3 g/dL postoperatively. She received the aforementioned combination of iron sucrose, erythropoietin, and vitamins. A total of 1,500 mg of intravenous iron sucrose was given postoperatively for 6 consecutive days. Erythropoietin was also administered at 2,000 IU every other day for a total of 12,000 IU. The patient was discharged in good condition on the twelfth postoperative day with a hemoglobin of 8.5 g/dL. Her hemoglobin was at 11.2 g/dL on the twentieth postoperative day.
authors.affiliation: Department of Internal Medicine, Himchan Hospital, Seoul, Korea.
authors.forename: Jiyeol
authors.initials: J
authors.lastname: Yoon
authors.forename: Sungmin
authors.initials: S
authors.lastname: Kim
authors.forename: Soo Chan
authors.initials: SC
authors.lastname: Lee
authors.forename: Hongsub
authors.initials: H
authors.lastname: Lim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000188:drug therapy*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D001803:Blood Transfusion; D004359:Drug Therapy, Combination; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage*; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid; D006801:Humans
chemical_list: D005290:Ferric Compounds; D004921:Erythropoietin; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid