儿童促红细胞生成素导致纯红细胞再生障碍性贫血1例与文献复习

摘要

Epoetin-associated pure red cell aplasia is a rare disease in children patients.We report the case of a 10-year-old female patient with end stage renal disease presenting refractory anemia during her regular hemodialysis therapy.She was finally diagnosed as epoetin-associated pure red cell aplasia with abnormal result of bone marrow aspiration and positive result of serum EPO antibody by Elisa.For this patient,EPO injection is ineffective.The child's anemia became more and more serious and she had to rely on frequent blood transfusion.After diagnosis,EPO is suggested to be stopped and immunosuppressive agent and renal transplant therapy were needed.%促红细胞生成素导致的纯红细胞再生障碍性贫血是儿童较为少见的疾病.本例慢性肾脏病V期患儿为维持性血液透析患者,存在难治的较为严重的贫血.通过其临床资料、抗体检测结果和骨髓穿刺结果等,最终确诊为促红素导致的纯红细胞再生障碍性贫血.停用促红素,予免疫抑制剂治疗,效果欠佳.提示当应用促红细胞生成素的患儿出现难以解释的贫血时应注意促红素导致的纯红细胞再生障碍性贫血的可能,避免仅给予反复输血等治疗.建议确诊后及时停用促红细胞生成素,酌情给予免疫抑制剂治疗或者肾移植干预.