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64 yrs old suffers RA, on DMARDs, developed Aplastic Anemia. On Cyclosporine, now kidneys on border line. Is ATG required ?

Hi my mother is 64 yrs old with a know case of RA for about 8 yrs. She was on DMARDs for 4 yrs which improved her condition with joint pain and swelling , however now she has developed Aplastic Anemia . She was on Cyclosporine 100Mg a day which improved her blood counts but her kidneys were going over the borderline. The doctor has reduced the cyclosporine to 50 mg now and we are seeing drop in blood count. So far we have given her 3 RBC transfusions of 2 bags each time. The last one lasted only 2 months. He is advicing for a ATG treatment. We are currently in a confused status as it may not be 100% safe and may have side effects. Please advice.
Asked On : Mon, 21 Jan 2013
Answers:  1 Views:  28
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Orthopaedic Surgeon, Joint Replacement 's  Response
Jul 2013
Hi, thanks for writing to HCM.

At the outset, I would like to tell you that NO THERAPY OR NO PROCEDURE IS 100% SAFE as there will be certain amount of risk involved in the form of complications or adverse reactions which are typical for that procedure.

Generally, ATG (anti thymocyte globulin) therapy is indicated in aplastic anemia when patients are not eligible for a Bone marrow transplantation.

As already mentioned, so many complications may occur during therapy with ATG but one has to weigh the benefits & risk involved in the procedure. If benefits outweigh the risks, accept it.

Hope this information is helpful . Good day
Answered: Thu, 18 Jul 2013
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