RESISTANCE TO RECOMBINANT ERYTHROPOIETIN IN A HEMODIALYSIS PATIENT WITH HETEROZYGOUS HEMOGLOBINOPATHY J-MEINUNG

The mechanism of resistance to recombinant human erythropoietin (EPO) in hemodialysis patients with hemoglobinopathy is not yet fully unders tood. Poor responses to EPO have been reported in anemic dialysis pati ents with sickle cell disease and thalassemia. We present the first ca se of a hemodialysis patient with EPO resistance and hemoglobin J-Mein ung, which is initially found by hemoglobin electrophoresis and finall y proven by molecular genetic analysis. Additionally, the patient was diagnosed as having chronic active hemolysis with hallmarks of splenom egaly, an increased serum bilirubin and reticulocyte index, and a redu ced haptoglobin level. We discuss the possible mechanisms and proper t reatment options in such patients with a poor response to EPO. (C) 199 7 by the National Kidney Foundation, Inc.