Resistance to recombinant erythropoietin in a hemodialysis patient with heterozygous hemoglobinopathy J-Meinung.

Abstract

The mechanism of resistance to recombinant human erythropoietin (EPO) in hemodialysis patients with hemoglobinopathy is not yet fully understood. Poor responses to EPO have been reported in anemic dialysis patients with sickle cell disease and thalassemia. We present the first case of a hemodialysis patient with EPO resistance and hemoglobin J-Meinung, which is initially found by hemoglobin electrophoresis and finally proven by molecular genetic analysis. Additionally, the patient was diagnosed as having chronic active hemolysis with hallmarks of splenomegaly, an increased serum bilirubin and reticulocyte index, and a reduced haptoglobin level. We discuss the possible mechanisms and proper treatment options in such patients with a poor response to EPO.

• Authors: D C Tarng, J G Chang, T P Huang
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 29 Issue 5 Pg. 769-72 (May 1997) ISSN: 0272-6386 [Print] United States
• PMID: 9159314 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Recombinant Proteins
• Erythropoietin
• Hemoglobin J

Topics

• Adult
• Base Sequence
• Erythropoietin (administration & dosage, antagonists & inhibitors)
• Hemoglobin J (analysis, genetics)
• Hemoglobinopathies (blood, diagnosis, genetics)
• Heterozygote
• Humans
• Kidney Failure, Chronic (blood, genetics, therapy)
• Male
• Molecular Sequence Data
• Polymerase Chain Reaction
• Recombinant Proteins
• Renal Dialysis