エポエチンベータ（遺伝子組換え）で治療した慢性腎不全患者にみられた高血圧性網膜症の1例

A case of hypertensive retinopathy secondary to renal failure and treatment with epoetin beta obtained by gene manipulation

　ヒトエリスロポエチンの遺伝子組換えと細胞培養による腎性貧血の治療薬であるヒトエリスロポエチン治療の1症例について報告した。症例は31歳男性で，本製剤投与中に視力低下はきたさなかったものの高血圧性網膜症を生じ，投与を中止することで速やかに軽快した。眼科領域ではまだ報告がない治療薬であるが，今後，透析患者を中心に多施設で利用されることが予想される。副作用として少ないながらも高血圧をきたすことがあり，透析医と眼科医が共同で管理をすべきと思われた。

Uremic anemia is generally ascribed to inade-quate secretion of erythropoietin, EPO. Human EPO has been gene-coded and cloned in cultured mammalian cells. Recombinant human EPO, rhEPO, or genetically recombined epoetin beta, became available for treatment of renal anemia. This agent is claimed to induce remarkable amelio-ration of renal anemia without serious side effects.

A 31-year-old had been diagnosed as renal failure 15 years before. He had been under hemodialysis for the past 29 months. Bilateral hypertensive retinopathy developed presumably caused by sys-temic hypertension and rhEPO. Fundus findings improved soon after discontinuation of treatment with rhEPO. The visual acuity was no serieously impaired throughout the course. This case illus-trates the possible deleterious effect to the eye in patients undergoing hemodialysis with additional rhEPO therapy.