A cautionary tale of a man with haemochromatosis, chronic kidney disease and anaemia referred for erythropoietin therapy

Abstract

Erythropoiesis stimulating agents (ESAs) are used to mange anaemia secondary to chronic kidney disease (CKD). ESAs have also been used to augment the rate of iron loss by phlebotomy in some iron storage disorders. We report the use of erythropoietin to allow enhanced iron removal in a man with both hereditary haemochromatosis and CKD. The patient subsequently presented with more severe anaemia that prompted a search for an underlying occult malignancy. The case history illustrates the importance of considering alternative causes for anaemia in patients with CKD. © 2009 The Author. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.