To the Editor.
—Since 1989, recombinant human erythropoietin has been available for management of the anemia of end-stage renal disease.1 There have been reports of the use of erythropoietin in the treatment of other anemias, including anemia of malignancy associated with bone marrow infiltration,2 anemia of prematurity,3 zidovudine-induced anemia in human immunodeficiency virus infection,4 anemia of myelodysplastic syndromes,5 and anemia of rheumatoid arthritis.6 I describe two patients who had hemolytic anemia due to red blood cell (RBC) fragmentation in association with prosthetic heart valves. They were treated with erythropoietin, which eliminated their need for blood transfusions.The first patient was a 75-year-old woman who had rheumatic heart disease and double valve replacement in December 1985 for aortic and mitral stenosis. She received a Starr-Edwards aortic valve and a Medtronic-Hall mitral valve. Eighteen years prior to her heart surgery, she had a splenectomy after a
Gitler B. Treatment of Hemolytic Anemia Due to Red Blood Cell Fragmentation Using Recombinant Human Erythropoietin. JAMA. 1995;274(4):300–301. doi:10.1001/jama.1995.03530040026023
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