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Nephrol Dial Transplant (2004) 19: 479-481
© ERA–EDTA 2004; all rights reserved

Case Report

Low-dose cyclosporin therapy for recombinant erythropoietin-induced pure red-cell aplasia

Jeremy S. Duffield1, Susan Mann1, Lichel Horn2 and Robin J. Winney1

1Department of Renal Medicine and 2Department of Haematology, Royal Infirmary, Lauriston Place, Edinburgh, UK

Correspondence and offprint requests to: Dr J. S. Duffield, NKRF Senior Research Fellow, Department of Renal Medicine, Royal Infirmary, Edinburgh EH3 9YW, UK. Email: j.duffield@ed.ac.uk

Keywords: anaemia; cyclosporin; erythropoietin; pure red-cell aplasia; renal impairment

The first 150 words of the full text of this article appear below.



   Introduction
 
Pure red-cell aplasia (PRCA) is an uncommon condition. It has been reported to occur in dialysis patients following recombinant erythropoietin therapy, initiated for treatment of anaemia of chronic renal failure [1–3]. In those patients, anti-erythropoietin antibodies have been recorded. Little is known of the natural history of this disease or the safest, most efficacious therapy. Here we describe a patient with only moderate renal impairment, who also developed epoetin-induced PRCA. Initial bone marrow histology failed to make a clear diagnosis. There was no spontaneous remission, but the patient was managed successfully with low-dose cyclosporin alone without compromising renal function.



   Case
 
A 46-year-old woman with a 28 year history of type I diabetes mellitus, diabetic nephropathy and hypertension attended the nephrology services with slowly declining chronic renal impairment. Her previous medical history was remarkable for diabetic microvascular disease (retinopathy, peripheral neuropathy), left below-knee amputation (1997) for Charcot joint, . . . [Full Text of this Article]



   Discussion
 


   Conclusion
 

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S. A. Summers, A. Matijevic, and M. K. Almond
Successful re-introduction of recombinant human erythropoietin following antibody induced pure red cell aplasia
Nephrol. Dial. Transplant., August 1, 2004; 19(8): 2137 - 2139.
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