Abstract
In a 70 year old man with primary glomerulonephritis, severe anemia occurred after 4 years on hemodialysis and rHu-EPO. The usual mechanisms of EPO-resistance were excluded. A bone marrow sample showed red all aplasia. No circulating EPO could be detected; the serum inhibited the growth of erythroid precursors in bone marrow cultures. Immunoprecipitation identified an IgG anti-EPO, still active against deglycosylated EPO, i.e. directed against the peptidic matrix. Its high neutralising capacity and the absence of any immune abnormality rule out an auto-antibody. Anti-rHu EPO immunisation is a very rare occurrence, made severe by transfusion-dependence and the risk of hemosiderosis. An immuno-modulating treatment can therefore be justified.
Publication types
-
Case Reports
-
English Abstract
MeSH terms
-
Aged
-
Anemia / blood
-
Anemia / drug therapy*
-
Anemia / etiology
-
Angiodysplasia / complications
-
Blood Transfusion
-
Bone Marrow / pathology
-
Cell Division / drug effects
-
Combined Modality Therapy
-
Digestive System / blood supply
-
Drug Resistance / immunology
-
Erythroid Precursor Cells / pathology
-
Erythropoietin / immunology*
-
Erythropoietin / therapeutic use
-
Granulocyte-Macrophage Colony-Stimulating Factor / pharmacology
-
Hematemesis / drug therapy
-
Hematemesis / etiology
-
Hematemesis / therapy
-
Humans
-
Immunoglobulin G / biosynthesis
-
Immunoglobulin G / immunology*
-
Isoantibodies / biosynthesis
-
Isoantibodies / immunology*
-
Kidney Failure, Chronic / complications
-
Kidney Failure, Chronic / therapy
-
Leukemia, Erythroblastic, Acute / pathology
-
Male
-
Melena / drug therapy
-
Melena / etiology
-
Melena / therapy
-
Recombinant Proteins / immunology
-
Recombinant Proteins / therapeutic use
-
Renal Dialysis
-
Tumor Cells, Cultured / drug effects
Substances
-
Immunoglobulin G
-
Isoantibodies
-
Recombinant Proteins
-
Erythropoietin
-
Granulocyte-Macrophage Colony-Stimulating Factor