EVIDENCE FOR IMPAIRED ERYTHROPOIETIN RESPONSE TO ANAEMIA IN RHEUMATOID DISEASE

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Abstract
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.

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