Acquired Pure Red Cell Aplasia and Recombinant Erythropoietin

Recombinant erythropoietin (rEPO)-associated immunologically driven acquired pure red cell aplasia (PRCA) is an underreported, potentially worsening clinical syndrome in the setting of treatment of anemia of chronic kidney disease. Most cases reported in world literature are related to different formulations of erythropoiesis-stimulating agents with an implication in diagnosis and management. This brief review highlights the clinical guidelines of rEPO usage in nephrology practice, the pathophysiologic mechanism of PRCA, clinical features, diagnosis, and suggested management protocols.