Use of erythropoietin in the severely anemic Jehovah's Witness patient

Case report and review of the literature

Phillip Rogers, David F. Volles

Research output: Contribution to journalArticle

Abstract

Objective: To describe and discuss the use of erythropoietin as a therapeutic option for treatment of severe anemia in a patient whose religious beliefs preclude the use of blood products. Case Summary: A 23- year-old male Jehovah's Witness patient presented to the emergency department with multiple fractures and significant blood loss secondary to trauma experienced in a motor vehicle accident. The patient refused transfusion because of his religious beliefs. He was given oxygen and lactated Ringer's solution, and phlebotomy was kept to a minimum. Erythropoietin was recommended to increase production of red blood cells. Review of the product information revealed that all available erythropoietin products contain human albumin as a stabilizer. After discussion with the clinical pharmacist, the patient and his family agreed to the use of erythropoietin. The patient's hematocrit and hemoglobin improved sufficiently for him to be taken to surgery on hospital day 12, and on hospital day 23 he was discharged. Discussion: Because Jehovah's Witnesses refuse to receive blood products, alternative methods for treatment of severe anemia must be used. Although some options are clearly unacceptable, certain volume expanders can be used in conjunction with oxygen and intravenous or oral iron that do not violate the patient's religious convictions. Erythropoietin is acceptable to most Jehovah's Witnesses; however, it contains human album (2.5 mg/mL), which may be of concern to some of these patients. Conclusions: Effective communication with the patient and the patient's family regarding all treatment options is required for treatment o severe anemia in the Jehovah's Witness patient. Erythropoietin, in conjunction with iron, adequate oxygenation, and good nutritional support, sometimes is an acceptable alternative in Jehovah's Witnesses.

Original languageEnglish (US)
Pages (from-to)252-257
Number of pages6
JournalJournal of Pharmacy Technology
Volume13
Issue number6
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Jehovah's Witnesses
Erythropoietin
Anemia
Religion
Iron
Oxygen
Therapeutics
Phlebotomy
Nutritional Support
Motor Vehicles
Hematocrit
Pharmacists
Accidents
Hospital Emergency Service
Albumins
Hemoglobins
Erythrocytes
Communication

All Science Journal Classification (ASJC) codes

  • Pharmaceutical Science

Cite this

Use of erythropoietin in the severely anemic Jehovah's Witness patient : Case report and review of the literature. / Rogers, Phillip; Volles, David F.

In: Journal of Pharmacy Technology, Vol. 13, No. 6, 01.01.1997, p. 252-257.

Research output: Contribution to journalArticle

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