Korean Journal of Nephrology 1992;11(2):180-186.
Hemosiderosis가 있는 만성 신부전환자에서 Erythropoieten 치료중에 발생한 대발작 1예
이기형 , 김문재 , 배창환
Abstract
Iron overload from repeated transfusions of RBC in long-term hemodialysis patients is a problem of increas- ing clinical significance. Use of recombinant human erythropoietin (rHuEPO) and phlebotomy is an effective and safe method of reducing iron overload in dialysis patient, We report on a 54-year-old woman using hemodialy- sis who had attacks of grand mal seizure during rHuE- PO treatment. She had a diagnosis of hemosiderosis with high serum ferritin (above 6000 ng/dl) from the study of abdominal CT scanning, liver and bone marrow biopsies 2 months before. So the rHuEPO (50 units/Kg) was given intravenously three times weekly immediately after dialysis for 8 weeks prior to seizure attacks. On admission after fits she was post-ictal with no focal neurological sign, her blood pressure was 230/110 mmHg and her hemoglobin concentration was 10. 3 g/gl. Results of biochemical tests were stable, and those of brain CT scan, cerebrospinal fluid pressure and os- molality were normal. Seizure subsided after repeated phlebotomy and aggressive control of high blood pressure, rHuEPO was temporarily stopped and 2 weeks later was resummed (25 units/Kg twice a week) with no more fit.
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