DOSE-ESCALATION INDUCES TOLERANCE TO SIDE-EFFECTS OF ERYTHROPOIETIN IN A PATIENT WITH DIALYSIS ANEMIA - CASE-REPORT

A 51-year-old woman began haemodialysis for chronic renal failure in F ebruary 1981. Symptomatic anaemia required treatment with recombinant human erythropoietin (rHuEPO) in February 1990 (3000 IU, twice weekly, intravenously). She developed influenza-like symptoms and treatment w as withdrawn. In June 1994 rHuEPO was resumed at a very low dose of 10 0 IU subcutaneously three times weekly, and was increased gradually to 500 IU, without inducing any side-effects. At this dose the haematocr it was maintained at 22.0 - 25.0% and the symptoms of anaemia improved . In patients like ours, with influenza-like symptoms caused by rHuEPO therapy, dose escalation starting from an ultra-low dose may be effec tive in avoiding side-effects.