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Case Reports in Transplantation
Volume 2015, Article ID 286276, 5 pages
http://dx.doi.org/10.1155/2015/286276
Case Report

Anti-Erythropoietin Antibody Associated Pure Red Cell Aplasia Resolved after Liver Transplantation

1Department of Internal Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA
2Department of Hepatology, California Pacific Medical Center, San Francisco, CA 94115, USA
3Department of Hematology Oncology, California Pacific Medical Center, San Francisco, CA 94115, USA

Received 23 January 2015; Accepted 29 June 2015

Academic Editor: Piero Boraschi

Copyright © 2015 Annie K. Hung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Patients undergoing antiviral therapy for chronic hepatitis C often develop anemia secondary to ribavirin and interferon. Recombinant erythropoietin has been used to improve anemia associated with antiviral therapy and to minimize dose reductions, which are associated with decreased rates of sustained virologic response. A rare potential side effect of recombinant erythropoietin is anti-erythropoietin antibody associated pure red cell aplasia. In chronic kidney disease patients with this entity, there have been good outcomes associated with renal transplant and subsequent immunosuppression. In this case, a chronic liver disease patient developed anti-erythropoietin associated pure red cell aplasia and recovered after liver transplantation and immunosuppression. It is unclear whether it is the transplanted organ, the subsequent immunosuppression, or the combination that contributed to the response. In conclusion, anti-erythropoietin associated pure red cell aplasia is a serious complication of erythropoietin therapy, but this entity should not be considered a contraindication for solid organ transplantation.