Successful Treatment of Antibody-mediated Pure Red Cell Aplasia Induced by Continuous Erythropoietin Receptor Activator with Prednisolone

• Published in: Internal Medicine Vol. 61; no. 14; pp. 2209 - 2213
• Main Authors: Okahashi, Nozomi, Kubo, Masayuki, Hoshino, Ei, Uchihara, Masahito, Amano, Itsuto, Tanaka, Haruyuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 15.07.2022; Japan Science and Technology Agency
• Subjects: anti-CERA antibody; anti-erythropoietin antibody; antibody-mediated pure red cell aplasia; Aplasia; Case Report; Case reports; continuous erythropoietin receptor activator; Erythropoiesis; erythropoiesis-stimulating agents; Erythropoietin; Internal medicine; Prednisolone; Reticulocytopenia; anti-CERA antibody; anti-erythropoietin antibody; continuous erythropoietin receptor activator; antibody-mediated pure red cell aplasia; erythropoiesis-stimulating agents
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.8823-21

Pure red cell aplasia (PRCA) associated with erythropoiesis-stimulating agents (ESAs), which were first reported in 1998, usually occurs with subcutaneous administration of epoetin alfa (Eprex®). Improvements in ESA storage, handling, and administration methods have reduced the PRCA incidence. Continuous erythropoietin receptor activator (CERA) is a third-generation ESA that is rarely reported to induce PRCA. We herein report a case of CERA-induced PRCA presenting with positive anti-erythropoietin (EPO) and anti-CERA antibodies, which was successfully treated with prednisolone. Clinicians should be aware of the possibility of antibody-mediated PRCA induced by an ESA in CKD patients with anemia with reticulocytopenia and low serum EPO levels.