Preterm infant with a late presentation of blueberry muffin lesions secondary to recombinant erythropoietin.
Our patient is a 26-week-old preterm female infant delivered by caesarean section secondary to severe maternal preeclampsia who had been receiving subcutaneous recombinant erythropoietin (r-EPO) for anemia of prematurity. At 8 weeks of age after 8 doses of r-EPO, the infant developed numerous non-blanching erythematous macules and patches located on the back, posterior shoulder, and posterior arms, concerning for late-onset blueberry muffin lesions. Biopsy of the lesions confirmed dermal hematopoiesis. After r-EPO was discontinued all skin lesions gradually resolved over a period of 2 weeks and never recurred.
University of Kansas Medical Center. jblackmon@kumc.edu.
Anand
A
Rajpara
Joseph
J
Blackmon
Rachel
R
Laarman
Robert
R
Skaggs
Ana
A
Liolios
Deede
D
Lui
Garth
G
Fraga
D000740:Anemia / Q000188:drug therapy; D020405:Dermis / Q000473:pathology*; D004900:Erythroblasts / Q000473:pathology; D004921:Erythropoietin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005317:Fetal Growth Retardation; D006411:Hematopoiesis, Extramedullary / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D020300:Intracranial Hemorrhages / Q000150:complications; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications; D012871:Skin Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology
D011994:Recombinant Proteins; D004921:Erythropoietin