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Year : 2015  |  Volume : 25  |  Issue : 6  |  Page : 366-369

Rituximab: A viable treatment option for epoetin-induced pure red cell aplasia

1 Department of Nephrology, Apollo Hopsitals, Chennai, Tamil Nadu, India
2 Department of Pathology, Apollo Hopsitals, Chennai, Tamil Nadu, India

Correspondence Address:
R A Annigeri
Department of Nephrology, Apollo Hospitals, Chennai - 600 006, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-4065.156897

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Pure red cell aplasia (PRCA) due to neutralizing antibodies can rarely develop following treatment with epoetin. The treatment of this condition is generally unsatisfactory and immunosuppression is often recommended, which improves chances of hematological recovery. We describe a case of PRCA due to neutralizing anti-epoetin antibodies following therapy with epoetin-α in a 68-year-old man on hemodialysis. He presented with severe transfusion-dependent anemia and was initially treated with prednisolone and oral cyclophosphamide. However, within 2 weeks the immunosuppressive drugs had to be stopped due to complications, following which he remained transfusion dependent. Subsequently, he was given two doses 700 mg each of rituximab following which there were hematological recovery and resolution of anti-epoetin antibodies.


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Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07