Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia

Introduction: Erythropoietin-induced pure red blood cell aplastic anemia (EPO-PRCA) is a rare anemia, which presents a significant treatment challenge, often necessitating the cessation of erythropoiesis-stimulating agents and the adoption of immunosuppressive therapies or renal transplan...

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Main Authors: Honghui Zeng, Hong He, Xintian Shi, Ying Wang, Xin Wei
Format: Article
Language:English
Published: Karger Publishers 2025-03-01
Series:Case Reports in Nephrology and Dialysis
Online Access:https://karger.com/article/doi/10.1159/000543844
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author Honghui Zeng
Hong He
Xintian Shi
Ying Wang
Xin Wei
author_facet Honghui Zeng
Hong He
Xintian Shi
Ying Wang
Xin Wei
author_sort Honghui Zeng
collection DOAJ
description Introduction: Erythropoietin-induced pure red blood cell aplastic anemia (EPO-PRCA) is a rare anemia, which presents a significant treatment challenge, often necessitating the cessation of erythropoiesis-stimulating agents and the adoption of immunosuppressive therapies or renal transplantation. Case Presentation: In the present case, the patient developed severe anemia after 2-year EPO treatment and was diagnosed with EPO-PRCA. The treatment with the full dose of corticosteroids and testosterone for 1 month failed to increase his hemoglobin level significantly. Therefore, the patient received the combination therapy of cyclosporine A (CsA) with rituximab, which effectively cleared the anti-EPO antibody. Then, roxadustat was given to improve renal anemia. As Hb level increased gradually, the patient was recovered from EPO-PRCA. Conclusion: This case reported an EPO-PRCA patient was successfully cured by the combination of CsA with rituximab and provided another choice for the treatment of EPO-PRCA in the future.
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publisher Karger Publishers
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series Case Reports in Nephrology and Dialysis
spelling doaj-art-cce97d19a31c4c938fcddfdb304a754d2025-08-20T03:09:48ZengKarger PublishersCase Reports in Nephrology and Dialysis2296-97052025-03-01151535910.1159/000543844Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic AnemiaHonghui ZengHong HeXintian ShiYing WangXin Wei Introduction: Erythropoietin-induced pure red blood cell aplastic anemia (EPO-PRCA) is a rare anemia, which presents a significant treatment challenge, often necessitating the cessation of erythropoiesis-stimulating agents and the adoption of immunosuppressive therapies or renal transplantation. Case Presentation: In the present case, the patient developed severe anemia after 2-year EPO treatment and was diagnosed with EPO-PRCA. The treatment with the full dose of corticosteroids and testosterone for 1 month failed to increase his hemoglobin level significantly. Therefore, the patient received the combination therapy of cyclosporine A (CsA) with rituximab, which effectively cleared the anti-EPO antibody. Then, roxadustat was given to improve renal anemia. As Hb level increased gradually, the patient was recovered from EPO-PRCA. Conclusion: This case reported an EPO-PRCA patient was successfully cured by the combination of CsA with rituximab and provided another choice for the treatment of EPO-PRCA in the future. https://karger.com/article/doi/10.1159/000543844
spellingShingle Honghui Zeng
Hong He
Xintian Shi
Ying Wang
Xin Wei
Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
Case Reports in Nephrology and Dialysis
title Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
title_full Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
title_fullStr Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
title_full_unstemmed Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
title_short Cyclosporine A Combined with Rituximab Successfully Treated Erythropoietin-Induced Pure Red Blood Cell Aplastic Anemia
title_sort cyclosporine a combined with rituximab successfully treated erythropoietin induced pure red blood cell aplastic anemia
url https://karger.com/article/doi/10.1159/000543844
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AT honghe cyclosporineacombinedwithrituximabsuccessfullytreatederythropoietininducedpureredbloodcellaplasticanemia
AT xintianshi cyclosporineacombinedwithrituximabsuccessfullytreatederythropoietininducedpureredbloodcellaplasticanemia
AT yingwang cyclosporineacombinedwithrituximabsuccessfullytreatederythropoietininducedpureredbloodcellaplasticanemia
AT xinwei cyclosporineacombinedwithrituximabsuccessfullytreatederythropoietininducedpureredbloodcellaplasticanemia