Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report
<p>Abstract</p> <p>Introduction</p> <p>Pure red cell aplasia due to anti-epoetin antibodies is a known complication of epoetin therapy for anemia due to chronic kidney disease. This disease has not previously been well described in the setting of therapy for chronic hep...
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| Format: | Article |
| Language: | English |
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BMC
2009-07-01
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| Series: | Journal of Medical Case Reports |
| Online Access: | http://www.jmedicalcasereports.com/content/3/1/7335 |
| _version_ | 1819134946150711296 |
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| author | Behler Caroline M Terrault Norah A Etzell Joan E Damon Lloyd E |
| author_facet | Behler Caroline M Terrault Norah A Etzell Joan E Damon Lloyd E |
| author_sort | Behler Caroline M |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Introduction</p> <p>Pure red cell aplasia due to anti-epoetin antibodies is a known complication of epoetin therapy for anemia due to chronic kidney disease. This disease has not previously been well described in the setting of therapy for chronic hepatitis C virus infection. While treatment for pure red cell aplasia due to anti-epoetin antibodies is usually with immunosuppressive therapy such as calcineurin inhibition, the safety of this treatment in chronic hepatitis C virus infection is unknown. To date, little has been published on the efficacy of rituximab on pure red cell aplasia due to anti-epoetin antibodies.</p> <p>Case presentation</p> <p>This report describes a 65-year-old Asian-American woman who developed pure red cell aplasia from high titer neutralizing anti-epoetin antibodies after epoetin-alfa therapy during ribavirin and peg-interferon treatment for chronic hepatitis C virus infection. We describe the outcome of her treatment with rituximab. The reticulocyte count increased, and anti-epoetin antibody titer decreased with a loss of neutralizing activity <it>in vitro</it>, leading to a reduction in blood transfusions, and eventual resolution of anemia, without reactivation of hepatitis C virus.</p> <p>Conclusion</p> <p>The diagnosis of pure red cell aplasia from anti-epoetin antibodies should be considered in patients undergoing therapy for chronic hepatitis C virus infection who develop severe anemia after administration of erythropoietin or darbepoetin. Though it is currently an off-label indication, rituximab is a therapeutic option for patients with pure red cell aplasia due to anti-epoetin antibodies.</p> |
| first_indexed | 2024-12-22T10:11:16Z |
| format | Article |
| id | doaj.art-e4c30d73c76943f686eb3cf7a7118607 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-22T10:11:16Z |
| publishDate | 2009-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-e4c30d73c76943f686eb3cf7a71186072022-12-21T18:29:52ZengBMCJournal of Medical Case Reports1752-19472009-07-0131733510.4076/1752-1947-3-7335Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case reportBehler Caroline MTerrault Norah AEtzell Joan EDamon Lloyd E<p>Abstract</p> <p>Introduction</p> <p>Pure red cell aplasia due to anti-epoetin antibodies is a known complication of epoetin therapy for anemia due to chronic kidney disease. This disease has not previously been well described in the setting of therapy for chronic hepatitis C virus infection. While treatment for pure red cell aplasia due to anti-epoetin antibodies is usually with immunosuppressive therapy such as calcineurin inhibition, the safety of this treatment in chronic hepatitis C virus infection is unknown. To date, little has been published on the efficacy of rituximab on pure red cell aplasia due to anti-epoetin antibodies.</p> <p>Case presentation</p> <p>This report describes a 65-year-old Asian-American woman who developed pure red cell aplasia from high titer neutralizing anti-epoetin antibodies after epoetin-alfa therapy during ribavirin and peg-interferon treatment for chronic hepatitis C virus infection. We describe the outcome of her treatment with rituximab. The reticulocyte count increased, and anti-epoetin antibody titer decreased with a loss of neutralizing activity <it>in vitro</it>, leading to a reduction in blood transfusions, and eventual resolution of anemia, without reactivation of hepatitis C virus.</p> <p>Conclusion</p> <p>The diagnosis of pure red cell aplasia from anti-epoetin antibodies should be considered in patients undergoing therapy for chronic hepatitis C virus infection who develop severe anemia after administration of erythropoietin or darbepoetin. Though it is currently an off-label indication, rituximab is a therapeutic option for patients with pure red cell aplasia due to anti-epoetin antibodies.</p>http://www.jmedicalcasereports.com/content/3/1/7335 |
| spellingShingle | Behler Caroline M Terrault Norah A Etzell Joan E Damon Lloyd E Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report Journal of Medical Case Reports |
| title | Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report |
| title_full | Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report |
| title_fullStr | Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report |
| title_full_unstemmed | Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report |
| title_short | Rituximab therapy for pure red cell aplasia due to anti-epoetin antibodies in a woman treated with epoetin-alfa: a case report |
| title_sort | rituximab therapy for pure red cell aplasia due to anti epoetin antibodies in a woman treated with epoetin alfa a case report |
| url | http://www.jmedicalcasereports.com/content/3/1/7335 |
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