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Case Reports
. 2012 Jun;39(3):221-223.
doi: 10.1159/000339260. Epub 2012 May 15.

Erythropoietin May Improve Anemia in Patients with Autoimmune Hemolytic Anemia Associated with Reticulocytopenia

Olga Arbach  1 , Robert Funck, Frank Seibt, Abdulgabar Salama
Affiliations
Case Reports

Erythropoietin May Improve Anemia in Patients with Autoimmune Hemolytic Anemia Associated with Reticulocytopenia

Olga Arbach et al. Transfus Med Hemother. 2012 Jun.

Abstract
in English, German

BACKGROUND: Management of patients with autoimmune hemolytic anemia (AIHA) and reticulocytopenia remains challenging. CASE REPORTS: Two patients with decompensated AIHA who were receiving immunosuppressive drugs were treated with erythropoietin (EPO). Administration of EPO increased reticulocyte counts and hemoglobin concentrations in both cases. One patient completely recovered following a short course of treatment. Hemolysis could be compensated in the second patient using only mild doses of immunosuppressive drugs in combination with EPO. CONCLUSION: The administration of EPO should be considered in patients with therapy-refractory AIHA, particularly in the presence of reticulocytopenia.

Hintergrund: Das Management von Patienten mit Autoim-munhämolytischer Anämie und begleitender Retikulozytopenie stellt nach wie vor eine Herausforderung dar.

Fallberichte: Zwei Patienten mit dekompensierter Autoim-munhämolytischer Anämie, die mit Immunsuppressiva behandelt wurden, erhielten additiv Erythropoetin (EPO). Die Gabe von EPO erhöhte die Retikulozytenzahl sowie die Hämoglobinkonzentration in beiden Fällen. Der erste Patient erholte sich nach kurzer Therapiedauer. Die Hämo-lyse konnte im zweiten Fall durch EPO und geringe Dosen von Immunsuppression kompensiert werden.

Schlussfolgerung: Der Einsatz von EPO sollte in Patienten mit thera-pierefraktären Verläufen der AIHA erwogen werden, vor allem in Fällen mit begleitender Retikulozytopenie.

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Figures

Fig. 1
Fig. 1
Course of treatment of a 23-year-old man with massive autoimmune hemolytic anemia. ▪ = Red blood cell units; Hb = hemoglobin concentrations; RPI = corrected reticulocyte production index; Cyclo = cyclophosphamide; Pred = prednisolone; Epo = erythropoietin;, biw = twice weekly.
Fig. 2
Fig. 2
A 78-year-old female with chronic autoimmune hemolytic anemia and renal failure. ▪ = Red blood cell unit; Hb = hemoglobin concentration; RPI = corrected reticulocyte production index; IvIg = intravenous immunoglobulin; Dexa = dexamethasone; Erypo = erythropoietin 336 μg.
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