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Correction of the anaemia of chronic renal failure by recombinant human erythropoietin results in a rise in packed cell volume with a consequent increase in blood viscosity,predisposing to increased vascular resistance and the development of hypertension.Increases in blood pressure have occurred in almost half the patients treated so far with erythropoietin, but of more serious concern is the development of seizures in seven of these patients in the United Kingdom.Although these bear similarities to hypertensive encephalopathy,their mechanism remains unclear.An episode of seizures associated with erythropoietin treatment in one of our patients has been reported.We describe here a subsequent seizure suffered by this patient 11 days after a blood transfusion and two similar episodes suffered by an anephric patient undergoing continuous ambulatory peritoneal dialysis.These episodes are of interest because of their resemblance to the seizures reported in association with erythropoietin treatment. |
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