Unexpected Beneficial Response to Etanercept Therapy in a Hemodialysis Patient with Ankylosing Spondylitis

Erythropoietin (EPO) defi ciency is the main cause of renal anemia. However, chronic infl ammation may be one of the important causes for EPO resistance in patients with renal anemia. Inhibition of erythropoiesis by cytokines such as tumour necrosis factor alpha (TNF-α) may play an important role. Etanercept, a recombinant dimeric fusion protein consisting of a TNF-α receptor ligand-binding region linked to the Fc portion of human IgG, is approved for use in the treatment of ankylosing spondylitis. Here, we present an end-stage renal failure patient with ankylosing spondylitis treated by etanercept and observed no need for erythropoietin during etanercept treatment.