促红细胞生成素抵抗性贫血中的“理想”甲状旁腺激素
"Ideal" parathyroid hormone in erythropoietin-stimulating agents-resistant anemia.
作者信息
Ashraf Bilal, Bat Taha, Weinberg Olga K, Moe Orson W, Ibrahim Ibrahim
机构信息
Division of Hematology and Oncology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas Texas USA.
Department of Pathology Hematopathology Section University of Texas Southwestern Medical Center Dallas Texas USA.
出版信息
EJHaem. 2021 Nov 24;3(1):159-162. doi: 10.1002/jha2.316. eCollection 2022 Feb.
Erythropoietin-stimulating agents (ESAs) have revolutionized anemia treatment in end-stage renal disease (ESRD), but ESA resistance is increasingly identified. Secondary hyperparathyroidism (SHP) is one cause of ESA resistance. We describe a patient with ESA-resistant, transfusion-dependent anemia and mild SHP with remodeling and reticulin fibrosis on bone marrow biopsy, all of which resolved with stricter SHP management. We identified 64 patients with anemia, ESRD, and bone marrow biopsy. The parathyroid hormone (PTH) range for bony remodeling was 183-16,161.9 pg/ml versus 90.8-3283 pg/ml. The PTH range for fibrotic changes was 183-2487 pg/ml versus 90.8-16,161.9 pg/ml. We found no clear PTH range predictive for bone marrow changes.
促红细胞生成素刺激剂（ESAs）彻底改变了终末期肾病（ESRD）的贫血治疗，但越来越多的人发现存在ESA抵抗。继发性甲状旁腺功能亢进（SHP）是ESA抵抗的一个原因。我们描述了一名患有ESA抵抗、依赖输血的贫血以及轻度SHP的患者，其骨髓活检显示有重塑和网状纤维纤维化，所有这些在更严格的SHP管理下都得到了解决。我们确定了64例患有贫血、ESRD且进行了骨髓活检的患者。骨重塑的甲状旁腺激素（PTH）范围为183 - 16,161.9 pg/ml，而纤维化改变的PTH范围为90.8 - 3283 pg/ml。骨重塑的PTH范围为183 - 2487 pg/ml，纤维化改变的PTH范围为90.8 - 16,161.9 pg/ml。我们未发现明确的可预测骨髓变化的PTH范围。
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