Ilan Y, Dranitzki-Elhallel M, Rubinger D, Silver J, Popovtzer M M
Nephrology Service, Hadassah University Hospital, Jerusalem, Israel.
Transplantation. 1994 Mar 15;57(5):661-4. doi: 10.1097/00007890-199403150-00005.
Erythrocytosis was found in 20 out of 127 patients who underwent renal transplantation (15.7%). Four were found to have elevated erythropoietin concentrations (139.7 +/- 22.0 microns/ml) and 7 had normal levels (52.3 +/- 84 microns/ml (normal -60). The growth of erythroid CFUs was found to be normal in all patients. Theophylline treatment was given to 11 patients. The patients were divided into 3 groups according to their response: (1) patients with high erythropoietin levels whose hematocrit decreased from 59.6% to 46.3% within 2 weeks of treatment in parallel with a fall in erythropoietin; (2) patients with normal erythropoietin levels in whom theophylline therapy reduced the hematocrit from 58.7% to 47.2%; and (3) patients in whom theophylline had no effect on their erythrocytosis. We conclude that erythrocytosis after renal transplantation is a heterogenous condition and that several mechanisms are involved. In some patients, high erythropoietin levels or high sensitivity to erythropoietin are associated with the erythrocytosis. Theophylline therapy is beneficial in more than 50% of the cases.
在127例接受肾移植的患者中，有20例出现红细胞增多症（15.7%）。其中4例促红细胞生成素浓度升高（139.7±22.0微克/毫升），7例促红细胞生成素水平正常（52.3±84微克/毫升（正常范围-60）。所有患者的红系集落形成单位生长均正常。11例患者接受了茶碱治疗。根据患者的反应将其分为3组：（1）促红细胞生成素水平高的患者，治疗2周内血细胞比容从59.6%降至46.3%，同时促红细胞生成素水平下降；（2）促红细胞生成素水平正常的患者，茶碱治疗使血细胞比容从58.7%降至47.2%；（3）茶碱对其红细胞增多症无影响的患者。我们得出结论，肾移植后红细胞增多症是一种异质性疾病，涉及多种机制。在一些患者中，促红细胞生成素水平高或对促红细胞生成素敏感性高与红细胞增多症有关。茶碱治疗在超过50%的病例中是有益的。
