Pure Red Cell Aplasia Induced Only by Intravenous Administration of Recombinant Human Erythropoietin

2011 ◽  
Vol 126 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Hiroaki Shimizu ◽  
Takayuki Saitoh ◽  
Fumie Ota ◽  
Takahiro Jimbo ◽  
Yoshito Tsukada ◽  
...  
Keyword(s):  
Intravenous Administration ◽  
Recombinant Human Erythropoietin ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Red Cell Aplasia ◽  
Human Erythropoietin

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.

STEROID-RESISTANT ACQUIRED PURE RED CELL APLASIA: A PARTIAL REMISSION INDUCED BY RECOMBINANT HUMAN ERYTHROPOIETIN

1991 ◽  
Vol 79 (1) ◽  
pp. 125-125 ◽  
Author(s):  
Carlo Finelli ◽  
Giuseppe Visani ◽  
Barbara Gamberi ◽  
Miriam Fogli ◽  
Annarita Cenacchi ◽  
...  
Keyword(s):  
Partial Remission ◽  
Recombinant Human Erythropoietin ◽  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
Steroid Resistant ◽  
Red Cell Aplasia ◽  
Human Erythropoietin

scholarly journals Measurement of Anti-Erythropoiesis-Stimulating Agent IgG4 Antibody as an Indicator of Antibody-Mediated Pure Red Cell Aplasia

2012 ◽  
Vol 20 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Dohan K. Weeraratne ◽  
Andrew J. Kuck ◽  
Narendra Chirmule ◽  
Daniel T. Mytych
Keyword(s):  
Pure Red Cell Aplasia ◽  
Red Cell ◽  
High Antibody ◽  
Red Cell Aplasia ◽  
Human Erythropoietin ◽  
Highly Sensitive ◽  
Specific Igg4 ◽  
Threatening Condition ◽  
Life Threatening ◽  
Igg4 Antibody

ABSTRACTPatients treated with erythropoietin-based erythropoiesis-stimulating agents (ESAs) can develop a rare but life-threatening condition called antibody-mediated pure red cell aplasia (amPRCA). The antibody characteristics in a nephrology patient with amPRCA include high antibody concentrations with neutralizing activity and a mixed IgG subclass including anti-ESA IgG4 antibodies. In contrast, anti-ESA IgG4 antibody is generally not detected in baseline samples and antibody-positive non-PRCA patients. Therefore, we validated a highly sensitive immunoassay on the ImmunoCAP 100 instrument to quantitate anti-ESA IgG4 antibodies using a human recombinant anti-epoetin alfa (EPO) IgG4 antibody as a calibrator. The biotinylated ESA was applied to a streptavidin ImmunoCAP, and bound anti-ESA IgG4 antibodies were detected using a β-galactosidase-conjugated mouse anti-human IgG4 antibody. The validated assay was used to detect anti-ESA IgG4 in amPRCA and non-PRCA patients. The immunoassay detected 15 ng/ml of human anti-EPO IgG4 antibody in the presence of a 200 M excess of human anti-ESA IgG1, IgG2, or IgM antibody and tolerated 2 μg/ml of soluble erythropoietin. All patient samples with confirmed amPRCA had measurable anti-ESA IgG4 antibodies. In addition, 94% (17/18) of non-PRCA patient samples were antibody negative or had below 15 ng/ml of anti-ESA IgG4 antibodies. This novel immunoassay can measure low-nanogram quantities of human anti-ESA IgG4 antibodies in the presence of other anti-ESA antibodies. An increased concentration of anti-ESA IgG4 antibody is associated with the development of amPRCA. We propose that the measurement of anti-ESA specific IgG4 antibodies may facilitate early detection of amPRCA in patients receiving all ESAs structurally related to human erythropoietin.

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