Pure red cell aplasia (PRCA) is a rare condition described in patients with chronic kidney disease during alpha-Epo treatment subcutaneous administered generated by anti-R-Epo antibodies. Recently two cases of PRCA have been reported in patients affected by myelodysplastic syndrome treated with R-Epo. We described one more case of PRCA in a patient with refractory anemia treated with R-Epo.

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