title: Rituximab: A viable treatment option for epoetin-induced pure red cell aplasia.
abstract: Pure red cell aplasia (PRCA) due to neutralizing antibodies can rarely develop following treatment with epoetin. The treatment of this condition is generally unsatisfactory and immunosuppression is often recommended, which improves chances of hematological recovery. We describe a case of PRCA due to neutralizing anti-epoetin antibodies following therapy with epoetin-α in a 68-year-old man on hemodialysis. He presented with severe transfusion-dependent anemia and was initially treated with prednisolone and oral cyclophosphamide. However, within 2 weeks the immunosuppressive drugs had to be stopped due to complications, following which he remained transfusion dependent. Subsequently, he was given two doses 700 mg each of rituximab following which there were hematological recovery and resolution of anti-epoetin antibodies.
authors.affiliation: Department of Nephrology, Apollo Hopsitals, Chennai, Tamil Nadu, India.
authors.forename: S A
authors.initials: SA
authors.lastname: Mahajan
authors.affiliation: Department of Nephrology, Apollo Hopsitals, Chennai, Tamil Nadu, India.
authors.forename: N
authors.initials: N
authors.lastname: Nandagopal
authors.affiliation: Department of Pathology, Apollo Hopsitals, Chennai, Tamil Nadu, India.
authors.forename: M
authors.initials: M
authors.lastname: Soni
authors.affiliation: Department of Nephrology, Apollo Hopsitals, Chennai, Tamil Nadu, India.
authors.forename: R A
authors.initials: RA
authors.lastname: Annigeri
keywords: Anti-epoetin antibodies; pure red cell aplasia; rituximab