Improvement in Erythropoieis-stimulating Agent-induced Pure Red-cell Aplasia by Introduction of Darbepoetin-alpha When the Anti-erythropoietin Antibody Titer Declines Spontaneously
Journal of Korean Medical Science
;
: 1676-1679, 2010.
Article
in English
| WPRIM
| ID: wpr-152646
ABSTRACT
Anti-erythropoietin antibodies usually cross-react with all kinds of recombinant erythropoietins; therefore, erythropoiesis-stimulating agent (ESA)-induced pure red-cell aplasia (PRCA) is not rescued by different ESAs. Here, we present a case of ESA-induced PRCA in a 36-yr-old woman with chronic kidney disease, whose anemic condition improved following reintroduction of darbepoetin-alpha. The patient developed progressive, severe anemia after the use of erythropoietin-alpha. As the anemia did not improve after the administration of either other erythropoietin-alpha products or erythropoietin-beta, all ESAs were discontinued. Oxymetholone therapy failed to improve the transfusion-dependent anemia and a rechallenge with ESAs continuously failed to obtain a sustained response. However, her anemia improved following reintroduction of darbepoetin-alpha at 3 yr after the initial diagnosis. Interestingly, anti-erythropoietin antibodies were still detectable, although their concentration was too low for titration. In conclusion, darbepoetin-alpha can improve ESA-induced PRCA when the anti-erythropoietin antibody titer declines and its neutralizing capacity is lost.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Oxymetholone
/
Bone Marrow Cells
/
Erythropoietin
/
Red-Cell Aplasia, Pure
/
Drug Hypersensitivity
/
Glomerulonephritis, IGA
/
Hematinics
/
Anemia
/
Kidney Failure, Chronic
/
Antibodies
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2010
Type:
Article
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