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Case Report
Recovery from anti-recombinant-human-erythropoietin associated pure red cell aplasia in end-stage renal disease patients after renal transplantation
1 Division of Nephrology, 2 Division of Hematology and 3 Laboratory Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand
Correspondence and offprint requests to: Kearkiat Praditpornsilpa, Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand. E-mail: kearkiat@hotmail.com
Keywords: Pure red cell aplasia; erythropoietin; renal transplantation
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Introduction |
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Since 1990, recombinant human erythropoietin (r-HuEPO) has been used for the treatment of anaemia of chronic renal failure (CRF). Correction of anaemia may improve cardiovascular as well as non-cardiovascular morbidity and mortality. Despite these potentially beneficial effects of r-HuEPO, some CRF patients who have previously or are currently using r-HuEPO have been reported to display suspected or confirmed pure red cell aplasia (PRCA) [1,2]. These patients developed an unexplained sudden decrease in their haemoglobin (Hgb) level. Anti-r-HuEPO antibody (Ab), which has been demonstrated in several studies [3–5], seems to be the proximate cause of the PRCA. Currently, there
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