Blunted erythropoietin response to anaemia in rheumatoid arthritis

Abstract

The relationship of serum immunoreactive erythropoietin to haemoglobin concentration was defined for 54 patients with rheumatoid arthritis (RA) and 41 patients with anaemia of varying aetiology (excluding pregnancy and renal insufficiency), not associated with RA. Significant inverse correlations between the logarithm of serum immunoreactive erythropoietin and the haemoglobin concentration were noted for the anaemic patients in both groups. The regression line for the RA patients had a similar slope, but a significantly lower y-intercept as compared to that for the non-RA patients. Erythropoietin levels were also significantly lower for the group of RA patients than for the group of non-RA patients when matched for comparable haemoglobin concentrations. These studies suggest that the erythropoietin response to anaemia in RA is intact but blunted relative to that for anaemia of other aetiologies. Lower levels of serum erythropoietin in anaemic RA patients may contribute to the pathogenesis of their anaemia.

Anemia of chronic disease and defective erythropoietin production in patients with celiac disease

“…[24][25][26][27] Our results hint at a defective production of endogenous erythropoietin, in addition to changes in iron homeostasis, as a pathogenetic mechanism of ACD. A defective production of erythropoietin for the degree of anemia has been reported in some studies on ACD, [28][29][30] although adequate erythropoietin levels were observed in ACD subjects with systemic juvenile chronic arthritis. 31 This could be due to differences in mechanisms and cytokines causing ACD.…”

Anemia of Chronic Disease in Ankylosing Spondylitis: Improvement Following Anti-TNF Therapy

“…[3] Anemia is the most frequent extra-articular manifestation of rheumatoid arthritis (RA) and is estimated to occur in 30% to 60% of patients. [4,5] Of the group classified as anemic, 77% were found to have ACD and 23% to have iron deficiency anemia (IDA). [6] Rheumatoid arthritis patients with anemia have evidence of more severe disease, with more involved joints and higher levels of functional disability and pain.…”

Effect of Daily Subcutaneous Administration of Recombinant Erythropoietin on Chronic Anemiain Rheumatoid Arthritis.

“…Initial studies using the polycythemic mousebioassay suggested that serum erythropoietin (EPO) levels were low or absent in RA (2,3). Recent studies using a specific radioimmunoassay clearly demonstrated that serum EPO response to anemia in RAis relatively blunted comparedto that for anemiaof other etiologies except for pregnancy and renal disease (4). Recombinant EPO (rEPO) has been documented to be effective in correction of anemia in patients with chronic renal failure (CRF), which is characterized by insufficient production of EPO (5-7).…”