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[抗促红细胞生成素抗体诱导的纯红细胞再生障碍性贫血(PRCA):流行病学、诊断与治疗]

[Pure red cell aplasia (PRCA) induced by anti-EPO antibodies: epidemiology, diagnosis and treatment].

作者信息

Janda Katarzyna, Kraśniak Andrzej, Krzanowski Marcin, Sułowicz Władysław

机构信息

Katedra i Klinika Nefrologii, UJCM w Krakowie.

出版信息

Przegl Lek. 2010;67(3):187-91.

Abstract

Pure red-cell aplasia (PRCA) is a serious, life threatening rare condition of multifactorial causes manifested as severe anemia with absence of erythroid precursors in the bone marrow. PRCA may be a consequence of antibody production against applied recombinant human erythropoietin (EPO). The first description of PRCA in the course of EPO therapy was performed in a patient receiving subcutaneously Eprex and in the next years after therapy with other erythropoiesis stimulating agents like erythropoietin beta, omega or darbepoetin. In the paper we describe epidemiology and diagnostic criteria of PRCA. The current treatment possibilities of this complication were described with special attention dedicated to different immunosuppressive agents and effectiveness of kidney transplantation with subsequent immunosuppression.

摘要

纯红细胞再生障碍性贫血(PRCA)是一种严重的、危及生命的罕见病症,由多种因素引起,表现为严重贫血且骨髓中缺乏红系前体细胞。PRCA可能是针对应用的重组人促红细胞生成素(EPO)产生抗体的结果。在EPO治疗过程中对PRCA的首次描述是在一名接受皮下注射益比奥的患者中进行的,在随后几年中,在使用其他促红细胞生成刺激剂(如促红细胞生成素β、ω或达比加群)治疗后也有相关描述。在本文中,我们描述了PRCA的流行病学和诊断标准。阐述了这种并发症当前的治疗可能性,并特别关注了不同的免疫抑制剂以及肾移植及后续免疫抑制的有效性。

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