| Popis: |
A 45-year-old woman who had undergone bilateral nephrectomy and splenectomy and who had been under haemodialysis since 1966 developed non-A non-B cytolytic hepatitis in October, 1978. Her haematocrit and haemoglobin levels had been stable at 39% and 6 g/dl respectively for more than one year when, two months after the onset of hepatitis, spontaneous improvement of anaemia was observed. This persisted side-by-side with hepatic cytolysis until march, 1980. At that time, the total red cell volume was 24% above normal, the haematocrit was 41% and the haemoglobin level 13 g/dl. It was than that serum erythropoietin was measured and found to be 82 mU/ml (normal values : 5-10 mU/ml). During the following months hepatic cytolysis and polycythaemia gradually subsided, and the serum erythropoietin level decreased. This case suggests that extrarenal erythropoietin can be secreted by the liver in anephric adults with uraemia, that hepatocytes undergoing regeneration after cytolysis in adults may have the same capability or erythropoietin secretion as in foetuses, and that in some haemodialyzed patients bone marrow responses to erythropoietin remains unaltered. |
