Management of Anaemia of Chronic Kidney Disease Complicated with Allo-Immunization in Sickle Cell Anaemia Using DoubleDose Erythropoietin: A Case Report

Chronic blood transfusion has been recorded in several cases of sickle cell due to background haemolysis. Significant end organ failure consequent upon chronic vaso-occlusion also occurs as a hallmark of the disease. Chronic kidney disease may occur as an end event arising from several pathogenetic disease processes involving the kidneys in sickle cell. This is a case of chronic kidney disease sickle cell disease in an adult female, who developed chronic kidney disease (CKD) post-delivery with consequent transfusion dependence. Occurrence of pan-agglutination and recurrent haemolysis post-transfusion further complicated the clinical picture. Patient however responded to a double dose (8,000 IU) of Erythropoieitin (Epo) and iron and has become transfusion-independent. Higher doses of Epo may be helpful in overcoming Epo-resistance in sickle cell disease with nephropathy.