Erythrocytosis associated with increased serum erythropoietin in a patient on hemodialysis

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  • Matsuura Tomokazu
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Ryuzaki Munekazu
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Asanagi Mika
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Sakata Katsufumi
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Oku Kayo
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Kobayashi Emi
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Aoki Hirotoshi
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital
  • Handa Michiko
    Department of Internal Medicine, Kawasaki Municipal Ida Hospital

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Other Title
  • 血中エリスロポエチン高値の多血症を呈した維持透析患者の１例
  • 症例報告 血中エリスロポエチン高値の多血症を呈した維持透析患者の1例
  • ショウレイ ホウコク ケッチュウ エリスロポエチン コウチ ノ タケツショウ オ テイシタ イジ トウセキ カンジャ ノ 1レイ

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Abstract

The patient is a 56-year-old male undergoing hemodialysis since 1993. He was admitted to our hospital for the evaluation of erythrocytosis in 1997. His serum erythropoietin concentration was high. After some diagnostic investigations, the main causes of erythrocytosis were evaluated as sleep apnea syndrome, smoking, and hypotension during hemodialysis. Since sleep apnea syndrome had already been treated by otorhinological surgery, he was only prescribed weight control by dietary restriction and it was temporarily effective for controlling erythrocytosis. The evaluation of sleep apnea syndrome by apnomonitor was repeated in 2003, and the patient was classified as having severe disease. He, however, was again prescribed only weight control without continuous positive airway pressure (CPAP) therapy, because weight control had been effective. The patient was subsequently involved in a motor vehicle crash due to excessive daytime sleepiness. In this case, we should have initiated CPAP therapy earlier.

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