Two haemodialysis patients with epoetin alfa-induced pure red-cell aplasia recovered despite treatment with another epoetin preparation

BackgroundAnemia is a common complication of chronic renal failure due to reduce erythropoietin production by kidneys. Anemia treated with recombinant human erythropoietin (rHu-EPO). Pure red cell aplasia (PRCA) due to antibody productionagainst rHu-EPO is a rare but major complication of this drug. ObjectivesThe aim of this study was to determine the prevalence of PRCA due to antibodies in dialysis patients with resistant anemia who received erythropoietin. Patients and MethodsWe studied 128 under maintenance hemodialysis patients more than 3 month in Kashan. In patients with anemia who received erythropoietin with dose requirements based on weight and anemia and without any another cause for anemia, evaluate for PRCA and anti-rHu-EPO antibody level were measured by ELISA. ResultsIn this research, 75 patients (58.6%) were male and 53 patients (41.4%) were female. The mean age of the patients was 59.05 ± 16.66 years. The result of analysis showed that 55 (43%) patients had anemia with hemoglobin level less than 10 mg/dL. Only 3 patients had PRCA and antibodies against erythropoietin in serum. There were no correlation between age, gender, cause of renal failure, hemodialysis duration, hemoglobin level, rHu-EPO dose and levels of anti-rHu-EPO antibody serum value. ConclusionsThe result of this study indicated that administration of rHu-EPO in dialysis patients afflicted to kidney failure may cause PRCA especially through intravenous injection. However, this change is not statistically significant.

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“…Accordingly, Vartia et al reported two cases who received subcutaneous erythropoietin injection afflicted to PRCA (23). …”

Section: Discussionmentioning

confidence: 99%

Pure red cell aplasia due to antibody against erythropoietin in hemodialysis patients

et al. 2016

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“…[23][24][25][26] However, faced with ongoing and frequent red blood cell transfusion requirements, recent case reports describe individuals with epoetin-associated PRCA who recovered responsiveness to the same or different epoetin product following immunosuppressive therapy. [27][28][29][30][31][32][33] Worldwide, 19 of the 34 individuals who received epoetin after the onset of epoetin-associated PRCA regained epoetin responsiveness. The highest recovery rates (89%) were among individuals who received epoetin when antierythropoietin antibody levels were undetectable.…”

Section: Pure Red Cell Aplasia Antibodies and Epoetin 3345 Blood 1mentioning

confidence: 99%

Long-term outcome of individuals with pure red cell aplasia and antierythropoietin antibodies in patients treated with recombinant epoetin: a follow-up report from the Research on Adverse Drug Events and Reports (RADAR) Project

Bennett¹,

Cournoyer²,

Carson³

et al. 2005

Blood

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“…There are several cases of the successful re-introduction ("challenge") of ESA after the development of anti-EPO antibodies [32][33][34]. In the large patient group reported by Bennett et al [31], 57% of patients with anti-EPO antibodies developed EPO responsiveness after immunosuppression.…”

Section: Discussionmentioning

confidence: 99%

Anti-erythropoietin antibodies followed by endogenous erythropoietin production in a dialysis patient

et al. 2010

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We present a case of a young girl with end-stage renal disease secondary to anti-glomerular basement membrane disease who was receiving maintenance peritoneal dialysis and developed pure red cell aplasia secondary to anti-erythropoietin (EPO) antibodies. This occurred 13 months after the initiation of EPO alfa therapy for anemia. Initially, the patient required intermittent red blood cell transfusions. After immunosuppressive therapy had been initiated with corticosteroids and cyclosporine, the EPO antibody levels decreased precipitously, associated with an increased level of endogenous EPO production. For the following 6 months, the patient maintained adequate (>10 g/dL) hemoglobin levels and did not require red cell transfusions.

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Two haemodialysis patients with epoetin alfa-induced pure red-cell aplasia recovered despite treatment with another epoetin preparation

Cited by 11 publications

References 9 publications

Pure red cell aplasia due to antibody against erythropoietin in hemodialysis patients

Pure red cell aplasia due to antibody against erythropoietin in hemodialysis patients

Long-term outcome of individuals with pure red cell aplasia and antierythropoietin antibodies in patients treated with recombinant epoetin: a follow-up report from the Research on Adverse Drug Events and Reports (RADAR) Project

Anti-erythropoietin antibodies followed by endogenous erythropoietin production in a dialysis patient

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