scholarly journals Epoetin-associated pure red cell aplasia in patients with chronic kidney disease: solving the mystery

2005 ◽  
Vol 20 (suppl_3) ◽  
pp. iii33-iii40 ◽  
Author(s):  
Katia Boven ◽  
John Knight ◽  
Fred Bader ◽  
Jérome Rossert ◽  
Kai-Uwe Eckardt ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia

Roxadustat Improves Erythropoietin Antibody-Mediated Pure Red Cell Aplasia in a Patient with Hemodialysis

2021 ◽  
pp. 1-4
Author(s):  
Sijia Li ◽  
Xueqin Chen ◽  
Penghua Hu ◽  
Suijing Wu ◽  
Jianchao Ma ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Immunosuppressive Therapy ◽  
Recombinant Human Erythropoietin ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Common Complication ◽  
Normal Range ◽  
Red Cell Aplasia ◽  
Human Erythropoietin

Anemia is a common complication of chronic kidney disease (CKD). Recombinant human erythropoietin (rHu-EPO) is used extensively in patients with CKD. However, anti-erythropoietin (anti-EPO) antibody has been reported during rHu-EPO treatment, which causes pure red cell aplasia (PRCA). We presented a case of 75-year-old man, who underwent hemodialysis for 2 years. He developed PRCA during rHu-EPO treatment. The rHu-EPO was immediately discontinued, and the patient was given roxadustat treatment. After 6 months of roxadustat treatment, the anti-EPO antibody was disappeared, and hemoglobin recovered normal range. The results suggest that roxadustat can be used to treat patients with anti-EPO antibody-mediated PRCA without immunosuppressive therapy.

Hypersensitivity Syndrome and Pure Red Cell Aplasia Following Allopurinol Therapy in a Patient with Chronic Kidney Disease

2005 ◽  
Vol 39 (9) ◽  
pp. 1552-1556 ◽  
Author(s):  
Sheau-Chiou Chao ◽  
Chao-Chun Yang ◽  
Julia Yu-Yun Lee
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Drug Reaction ◽  
Kidney Disease ◽  
Hypersensitivity Syndrome ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Probability Scale ◽  
Naranjo Probability Scale ◽  
Red Cell Aplasia

OBJECTIVE: To report a rare case of combined hypersensitivity syndrome and pure red cell aplasia (PRCA) following allopurinol therapy. CASE SUMMARY: A 43-year-old woman with underlying mesangioproliferative glomerulonephritis developed fever, generalized morbilliform rash, leukocytosis with marked eosinophilia, and hepatic dysfunction 3 weeks after starting allopurinol therapy (300 mg/day for 3 days followed by 200 mg/day) for hyperuricemia and arthritis. The clinical findings were judged to be a probable drug reaction according to the Naranjo probability scale. The drug-induced hypersensitivity syndrome (DHS) resolved after withdrawal of allopurinol and initiation of systemic corticosteroid therapy. However, there was progressive worsening of anemia with reticulocytopenia; PRCA was suspected. PRCA was judged to be a possible drug reaction according to the Naranjo probability scale. The patient refused blood transfusion and bone marrow biopsy. Recombinant human erythropoietin was initiated in addition to prednisolone 15 mg daily. Eleven days later (~7 wk after allopurinol withdrawal), both the hemoglobin level and reticulocyte count began to rise. The patient consented to a bone marrow study at that time, which confirmed the presence of dysplasia involving only the erythroid lineage. DISCUSSION: Allopurinol may induce DHS, aplastic anemia, and, in rare instances, PRCA. We report the first case of PRCA concurrent with allopurinol-induced DHS in a patient with chronic kidney disease. Discontinuation of allopurinol is the first step in the treatment of such cases. The slow recovery of PRCA might be partly attributed to her underlying chronic kidney disease. CONCLUSIONS: To minimize serious DHS, proper indications for treatment and dosage adjustment should be closely observed when starting allopurinol therapy in patients with chronic kidney disease.

scholarly journals Epoetin-associated pure red cell aplasia in patients with chronic kidney disease: solving the mystery

2006 ◽  
Vol 21 (9) ◽  
pp. 2678-2678
Author(s):  
Katia Boven ◽  
John Knight ◽  
Fred Bader ◽  
Jérome Rossert ◽  
Kai-Uwe Eckardt ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia

scholarly journals Antibody-mediated pure red cell aplasia in chronic kidney disease patients receiving erythropoiesis-stimulating agents: new insights

2012 ◽  
Vol 81 (8) ◽  
pp. 727-732 ◽  
Author(s):  
Iain C. Macdougall ◽  
Simon D. Roger ◽  
Angel de Francisco ◽  
David J.A. Goldsmith ◽  
Huub Schellekens ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Erythropoiesis Stimulating Agents ◽  
Red Cell Aplasia

scholarly journals Factors associated with erythropoiesis-stimulating agent hyporesponsiveness anemia in chronic kidney disease patients.

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Kamalas Amnuay ◽  
Nattachai Srisawat ◽  
Kitsada Wudhikarn ◽  
Thamathorn Assanasen ◽  
Chantana Polprasert
Keyword(s):  
Chronic Kidney Disease ◽  
Bone Marrow ◽  
Kidney Disease ◽  
Pure Red Cell Aplasia ◽  
Serum Phosphate ◽  
Red Cell ◽  
Factors Associated ◽  
Bone Marrow Diseases ◽  
Bone Marrow Study ◽  
Common Problems

Anemia is one of the most common problems in chronic kidney disease (CKD). In several cases, despite comprehensive investigations, definite causes of anemia frequently remain unknown. We aimed to analyze the factors that possibly affect anemia in CKD patients who were referred for hematology consultation. A total of 87 patients were retrospectively included in the cohort. Forty-four cases were excluded, 30 cases with unavailable intact parathyroid hormone (iPTH) data, 11 cases with bone marrow diseases (8 Pure red cell aplasia, 3 Myelodysplastic syndrome) and 3 cases with thalassemia. Totally, 43 patients were analyzed. Patients with high iPTH had significantly lower Hemoglobin (Hb) level and required higher dose of erythropoietin stimulating agents (ESAs) compared with normal iPTH group (Hb 8.29 vs 9.24 mg/dL, p=0.032 and ESAs dose of 16,352.94 vs. 12,444.44 U/ week, p=0.024). In univariate followed by stepwise multivariate analysis, serum phosphate (PO4) was significantly associated with lower Hb level (p=0.01 and p=0.013, respectively). Hb level was inversely correlated with iPTH and PO4 level (r=-0.54, p<0.001 and r=-0.47, p=0.05; respectively). Mineral disequilibrium is an important factor associated with anemia in ESA hyporesponsive CKD. Hyperphosphatemia and secondary hyperparathyroidism are significantly correlated with low Hb. Therefore, we strongly suggest correction of these mineral disequilibrium factors prior to performing bone marrow study.

Pure red cell aplasia

2000 ◽  
Vol 111 (4) ◽  
pp. 1010-1022 ◽  
Author(s):  
Paul Fisch ◽  
Rupert Handgretinger ◽  
Hans-Eckart Schaefer
Keyword(s):  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia
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