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Rapid resolution of EPO-induced pure red cell aplasia after a course of immunoadsorption therapy using protein a columns

Westerlund, P; Kurkus, Jan LU and Segelmark, Mårten LU (2005) In American Journal of Kidney Diseases 45(6). p.97-99
Abstract
Pure red cell aplasia (PRCA) is a rare, but important, complication of erythropoietin (EPO) replacement therapy in patients with renal disease. There is no consensus about the best way to treat this condition; however, recent reports indicated that immunosuppressive therapy is beneficial. We report a patient with EPO-induced PRCA treated with a regimen initially designed for antifactor VIII antibodies in patients with hemophilia. This regimen consists of immunoadsorption therapy using protein A columns, followed by oral prednisolone and single bolus infusions of intravenous immunoglobulin G and cyclophosphamide. Shortly after the course, a swift and rapid increase in reticulocyte count was evident; the patient became transfusion... (More)
Pure red cell aplasia (PRCA) is a rare, but important, complication of erythropoietin (EPO) replacement therapy in patients with renal disease. There is no consensus about the best way to treat this condition; however, recent reports indicated that immunosuppressive therapy is beneficial. We report a patient with EPO-induced PRCA treated with a regimen initially designed for antifactor VIII antibodies in patients with hemophilia. This regimen consists of immunoadsorption therapy using protein A columns, followed by oral prednisolone and single bolus infusions of intravenous immunoglobulin G and cyclophosphamide. Shortly after the course, a swift and rapid increase in reticulocyte count was evident; the patient became transfusion independent and has remained so during 2 years of follow-up. By means of this report, we wish to encourage others to consider this option when first-line treatments fail. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
immunoadsorption, protein A, erythropoietin (EPO), pure red cell aplasia
in
American Journal of Kidney Diseases
volume
45
issue
6
pages
97 - 99
publisher
Elsevier
external identifiers
  • wos:000229857000028
  • pmid:15957124
  • scopus:20444401927
ISSN
1523-6838
DOI
10.1053/j.ajkd.2005.03.011
language
English
LU publication?
yes
id
2459a960-a36a-45cf-9ab4-f77baf1989a3 (old id 235962)
date added to LUP
2007-08-23 18:31:30
date last changed
2017-01-01 04:52:03
@article{2459a960-a36a-45cf-9ab4-f77baf1989a3,
  abstract     = {Pure red cell aplasia (PRCA) is a rare, but important, complication of erythropoietin (EPO) replacement therapy in patients with renal disease. There is no consensus about the best way to treat this condition; however, recent reports indicated that immunosuppressive therapy is beneficial. We report a patient with EPO-induced PRCA treated with a regimen initially designed for antifactor VIII antibodies in patients with hemophilia. This regimen consists of immunoadsorption therapy using protein A columns, followed by oral prednisolone and single bolus infusions of intravenous immunoglobulin G and cyclophosphamide. Shortly after the course, a swift and rapid increase in reticulocyte count was evident; the patient became transfusion independent and has remained so during 2 years of follow-up. By means of this report, we wish to encourage others to consider this option when first-line treatments fail.},
  author       = {Westerlund, P and Kurkus, Jan and Segelmark, Mårten},
  issn         = {1523-6838},
  keyword      = {immunoadsorption,protein A,erythropoietin (EPO),pure red cell aplasia},
  language     = {eng},
  number       = {6},
  pages        = {97--99},
  publisher    = {Elsevier},
  series       = {American Journal of Kidney Diseases},
  title        = {Rapid resolution of EPO-induced pure red cell aplasia after a course of immunoadsorption therapy using protein a columns},
  url          = {http://dx.doi.org/10.1053/j.ajkd.2005.03.011},
  volume       = {45},
  year         = {2005},
}