Cyclic thrombocytopenia related to erythropoietin-dependent anti-platelet anti-GPIV/IIIb antibody in hemodialysis
Tóm tắt
We describe herein the case of a 65-year-old patient on chronic hemodialysis with a medical history of idiopathic thrombocytopenia who experienced numerous episodes of severe thrombocytopenia with no specific diagnosis. Further analysis of the evolution of the platelet count showed that cyclic thrombocytopenia occurred after each injection of recombinant erythropoietin (rHu-EPO). Exploration of the involved mechanisms revealed the presence of a rHu-EPO-dependent anti-GPIV/IIIb antibody associated with a significant increase in GPIV/IIIb expression on her platelets after the addition of rHu-EPO. EPO was discontinued and the patient was treated with roxadustat with favorable results on her hemoglobin and platelet counts.
Tài liệu tham khảo
Chateauvieux S, Grigorakaki C, Morceau F, Dicato M, Diederich M (2011) Erythropoietin, erythropoiesis and beyond. Biochem Pharmacol 82:1291–1303
Casadevall N et al (1996) Autoantibodies against erythropoietin in a patient with pure red-cell aplasia. N Engl J Med 334:630–633
Casadevall N et al (2002) Pure red-cell aplasia and antierythropoietin antibodies in patients treated with recombinant erythropoietin. N Engl J Med 346:469–475
Beguin Y (1999) Erythropoietin and platelet production. Haematologica 84:541–547
Stohlawetz PJ et al (2000) Effects of erythropoietin on platelet reactivity and thrombopoiesis in humans. Blood 95:2983–2989
Eschbach JW et al (1989) Recombinant human erythropoietin in anemic patients with end-stage renal disease. Results of a phase III multicenter clinical trial. Ann Intern Med 111:992–1000
McDonald TP, Clift RE, Cottrell MB (1992) Large, chronic doses of erythropoietin cause thrombocytopenia in mice. Blood 80:352–358
Shin SK et al (2011) Anti-erythropoietin and anti-thrombopoietin antibodies induced after administration of recombinant human erythropoietin. Int Immunopharmacol 11:2237–2241
Aster RH, Bougie DW (2007) Drug-induced immune thrombocytopenia. N Engl J Med 357:580–587
Smith KJ, Bleyer AJ, Little WC, Sane DC (2003) The cardiovascular effects of erythropoietin. Cardiovasc Res 59:538–548
Demetz G et al (2014) The influence of Erythropoietin on platelet activation, thrombin generation and FVII/active FVII in patients with AMI. Thromb J 12:18
Gambardella L et al (2016) Gender difference in platelet aggregation and reactivity induced by recombinant human erythropoietin. Br J Clin Pharmacol 81:789–791
Gupta N, Wish JB (2017) Hypoxia-inducible factor prolyl hydroxylase inhibitors: a potential new treatment for anemia in patients with CKD. Am J Kidney Dis 69:815–826
Egrie JC, Browne JK (2001) Development and characterization of novel erythropoiesis stimulating protein (NESP). Br J Cancer 84:3–10