Korean J Intern Med.  2010 Dec;25(4):454-457. 10.3904/kjim.2010.25.4.454.

Postoperative High-Dose Intravenous Iron Sucrose with Low Dose Erythropoietin Therapy after Total Hip Replacement

• Yoon J
• Kim S
• Lee SC
• Lim H

• KMID: 964729
• DOI: http://doi.org/10.3904/kjim.2010.25.4.454

Abstract

Erythropoietin combined with parenteral iron sucrose therapy is an alternative to blood transfusion in anemic patients. It was shown to be effective in surgical patients in several previous studies when used in conjunction with other methods. However, there are no guidelines about safety limits in dosage amounts or intervals. In this study, we report a case of significant postoperative hemorrhage managed with high dose parenteral iron sucrose, low dose erythropoietin, vitamin B12, vitamin C, and folic acid. An 80-year-old female patient presented for severe anemia after a total hip arthroplasty and refused an allogenic blood transfusion as treatment. The preoperative hemoglobin of 12.2 g/dL decreased to 5.3 g/dL postoperatively. She received the aforementioned combination of iron sucrose, erythropoietin, and vitamins. A total of 1,500 mg of intravenous iron sucrose was given postoperatively for 6 consecutive days. Erythropoietin was also administered at 2,000 IU every other day for a total of 12,000 IU. The patient was discharged in good condition on the twelfth postoperative day with a hemoglobin of 8.5 g/dL. Her hemoglobin was at 11.2 g/dL on the twentieth postoperative day.

Keyword

Ferric oxide, saccharated; Epoetin alpha; Arthroplasty

MeSH Terms

Aged
Aged, 80 and over
Anemia/*drug therapy
Arthroplasty, Replacement, Hip/*adverse effects
Blood Transfusion
Drug Therapy, Combination
Erythropoietin/*administration & dosage
Female
Ferric Compounds/*administration & dosage
Humans