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Serum erythropoietin concentration in anaemia of visceral leishmaniasis (kala‐azar) before and during antimonial therapy
Author(s) -
Saeed Amal M.,
Khalil Eltahir A. G.,
Elhassan Afaf M. A.,
Hashim Faisal A.,
Elhassan Ahmed M.,
Fandrey Joachim,
Jelkmann Wolfgang
Publication year - 1998
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.1998.00624.x
Subject(s) - sodium stibogluconate , erythropoietin , medicine , anemia , red blood cell , ferritin , immunology , pharmacology , visceral leishmaniasis , leishmaniasis , endocrinology
Serum erythropoietin (Epo) concentrations and variables of red cell and iron status were studied in 27 Sudanese patients who were treated with sodium stibogluconate for visceral leishmaniasis (kala‐azar). Blood haemoglobin increased from 6.4 (±1.7 SD) to 9.5 (±1.4) g/dl during treatment. Serum ferritin decreased concomitantly. Serum iron levels were unchanged whereas the total iron binding capacity increased slightly. The pre‐treatment serum Epo concentration in relation to the blood haemoglobin concentration was not as high as expected from the one in primary haematological diseases, indicating that there is a relative lack of Epo in anaemic kala‐azar patients. Serum Epo further decreased during stibogluconate therapy. The normal dependence of the serum Epo level on the blood haemoglobin concentration was lost during mid‐term antimonial treatment, but it recovered thereafter. Cell culture studies with the human hepatoma cells HepG2 showed that stibogluconate ( 30 μg/ml) inhibited Epo gene expression. Thus, effective treatment of kala‐azar with stibogluconate results in improvement of anaemia, although the drug itself may impair Epo production.