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© 1991 British Society for Rheumatology

research-article

EVIDENCE FOR IMPAIRED ERYTHROPOIETIN RESPONSE TO ANAEMIA IN RHEUMATOID DISEASE

H. K. BOYD, T. R. J. LAPPIN and A. L. BELL*

Department of Haematology, Royal Victoria Hospital and The Queen's University of Belfast
*Department of Rheumatology, Royal Victoria Hospital and The Queen's University of Belfast

Correspondence to: Correspondence to Dr H. K. Boyd. Department of Haematology, Royal Victoria Hospital. Grosvenor Road. Belfast BT12 6BA

In this study we determined the serum erythropoietin (Epo) levels of 97 anaemic rheumatoid (RD) patients (Hb< 11 g/dl) of whom 44 had serum ferritin >60 µg/l (anaemia of chronic disorders; ACD), 26 had ferritin 20–60 µg/l and 27 had ferritin <20 µg/l. These results were compared with the Epo levels of 36 iron deficient controls (Hb<11 g/dl), 33 non-anaemic RD patients and 33 normals. The serum Epo levels of anaemic subjects were significantly higher (P<0.05) than those of non-anaemic patients. Despite similar Hb, the Epo results (geometric mean (confidence limits)) of the ACD group (38 (32,45) mU/ml) and of RD patients with ferritin of 20/60 .µg/l (39 (33,46)mU/ml) were significantly lower (P<0.05) than those of iron deficient controls (65 (52,80)mU/ml). When the Hb fell to 10 g/dl or less, the serum Epo of 13 RD patients with ferritin <20 µg/l was 65 (47,89)mU/ml, significantly lower (P<0.05) than that of 17 iron deficient controls (104 (78,136)mU/ml). These results justify clinical trials of recombinant human Epo in RD patients with ACD.

KEY WORDS: Haemoglobin, Serum ferritin, Serum erythropoietin


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