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NDT Advance Access originally published online on February 21, 2007
Nephrology Dialysis Transplantation 2007 22(5):1462-1464; doi:10.1093/ndt/gfl727
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Antibody-mediated acquired pure red cell aplasia (PRCA) after treatment with darbepoetin

Rebecca Howman1 and Hemant Kulkarni2

1Department of Haemotology and 2Nephrology, Fremantle Hospital, Fremantle, Western Australia

Correspondence and offprint requests to: Dr Hemant A. Kulkarni, MD, MRCP, FRACP; Renal Physician, Fremantle Hospital, 2 Alma Street, Fremantle, Western Australia 6160. Email: hemant.kulkarni@health.wa.go.au

Keywords: antibody-mediated PRCA; darbepoetin; pure red cell aplasia

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



   Introduction
 
Recombinant erythropoietin (EPO) is used successfully as treatment for anaemia in chronic kidney disease (CKD), to maintain stable haemoglobin levels, avoiding the need for multiple transfusions. From 1998, epoetin formulations, in particular epoetin alfa (Eprex®, Ortho Biologics LLC), have been associated with a substantial increase in the incidence of antibody (Ab)-mediated pure red cell aplasia (PRCA) [1]. PRCA is a rare immunopathological disorder characterized by a severe reticulocytopenia, the absence of marrow erythroid precursors, normal granulocytic and megakaryocytic precursors, and the identification of circulating antibodies against EPO [2]. Patients typically develop an abrupt onset of severe transfusion-dependent anaemia. Consequently, EPO must be withdrawn and therapy initiated to decrease the production of the anti-EPO antibodies.

Darbepoetin alfa (Aranesp®, Amgen Inc., CA) is a second generation erythropoiesis stimulating agent with two extra carbohydrate chains and eight extra sialic acid residues as compared with epoetin alfa. It is suggested . . . [Full Text of this Article]



   Case
 


   Discussion
 

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