Abstract
After liver transplantation, reinfection of the newly engrafted liver with hepatitis C virus is essentially universal in patients who are viremic at the time of transplantation. Treatment with interferon preparations with or without ribavirin is recommended in patients with marked histologic injury; however, hematologic toxicity associated with therapy has been reported, which is usually treated with growth factor support, including erythropoietin analogues. We present the first reported case of anti-erythropoietin antibody-mediated pure red cell aplasia arising in the setting of hepatitis C virus therapy in a patient who underwent living donor liver transplantation.
(c) 2007 AASLD.
MeSH terms
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Anemia / chemically induced
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Anemia / drug therapy
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Anemia / physiopathology
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Antibodies / blood
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Antiviral Agents / adverse effects*
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Epoetin Alfa
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Erythropoietin / adverse effects*
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Erythropoietin / immunology
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Graft Rejection / prevention & control
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Hematinics / therapeutic use
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Hepatitis C / drug therapy*
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Hepatitis C / prevention & control
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Humans
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Immunocompromised Host*
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Immunosuppressive Agents / therapeutic use
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Interferon alpha-2
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Interferon-alpha / therapeutic use
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Liver Transplantation*
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Living Donors
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Male
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Middle Aged
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Mycophenolic Acid / analogs & derivatives
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Mycophenolic Acid / therapeutic use
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Polyethylene Glycols
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Prednisone / therapeutic use
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Recombinant Proteins
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Red-Cell Aplasia, Pure / complications
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Red-Cell Aplasia, Pure / immunology*
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Red-Cell Aplasia, Pure / physiopathology
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Ribavirin / therapeutic use
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Secondary Prevention
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Tacrolimus / therapeutic use
Substances
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Antibodies
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Antiviral Agents
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Hematinics
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Immunosuppressive Agents
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Interferon alpha-2
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Interferon-alpha
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Recombinant Proteins
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Erythropoietin
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Polyethylene Glycols
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Ribavirin
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Epoetin Alfa
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peginterferon alfa-2b
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Mycophenolic Acid
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Prednisone
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Tacrolimus