Korean J Med.
2004 Nov;67(Suppl 3):S794-S798.
A case of pure red cell aplasia in a chronic hemodialysis patient with erythropoietin-resistant anemia
- Affiliations
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- 1Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. hyekim@chungbuk.ac.kr
- 2Department of Laboratory Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
- 3Dr. Earm's Medical Clinic, Korea.
Abstract
- The resistance to recombinant human erythropoietin (r-HuEPO) in patients with chronic renal failure can develop in conditions such as iron deficiency, chronic bleeding, or chronic inflammatory disease. Recently, there have been several case reports of pure red cell aplasia due to antibody production to r-HuEPO in chronic hemodialysis patients. A 59-year old female undergoing chronic hemodialysis responded well to r-HuEPO for 6 years. But, a rapidly progressive anemia was then noted which was unresponsive to maximal doses of r-HuEPO and the patient became transfusion-dependent. Bone marrow examination showed absence of red cell precursors. A detailed search for the cause of this pure red cell aplasia was unrevealing. We conclude that although very rare, pure red cell aplasia should be considered in evaluating chronic hemodialysis patients with erythropoietin-resistant anemia.
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