title: Antibody-mediated pure red cell aplasia (PRCA) on switching from darbepoetin alfa to epoetin beta: what are the implications?
abstract: We report the development of antibody-mediated pure red cell aplasia (PRCA) in a 63-year-old man with end-stage renal disease following a switch from darbepoetin alfa to epoetin beta. Haemoglobin levels began to decrease 6 months after the switch. Increasing the epoetin beta dose produced no response and regular blood transfusions were required; PRCA was confirmed and epoetin beta was discontinued. The patient responded positively to immunosuppression; after 2 months on prednisone and cyclophosphamide, haemoglobin levels stabilized and no further transfusions were required. This case highlights the difficulty in establishing a cause-effect relationship where more than one erythropoiesis-stimulating agent is involved.
authors.affiliation: Kidney Centre, Fresenius Medical Care, Setúbal , Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Assunção
authors.affiliation: Kidney Centre, Fresenius Medical Care, Setúbal , Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Vinhas
keywords: darbepoetin alfa; epoetin beta; erythropoiesis-stimulating agents; pure red cell aplasia