Erythropoietin EPO , a renal type I cytokine, plays key role in the regulation of erythropoiesis. EPO is also increased at the area of inflammation in addition to erythropoiesis and hypoxia showing an anti-inflammatory mechanism. EPO shows non-erythropoietic functions such as immunoregulatory effect in autoimmune diseases and tissue protective effect in trauma and ischemia. We aimed that whether there is a significant difference between erythropoietin EPO levels in patients who were administrated to emergency department with urticaria, angioedema and anaphylaxis or not.
Our study was conducted prospectively in ED during two years. Exclusion criteria: Patients who refused to participate, with previously known anemia, renal failure, liver disease, chronic obstructive pulmonary disease, asthma, any disease affecting bone marrow, and malignancies. Of 38 anaphylaxis patients, There was no significant difference, in terms of erythropoietin and related parameters among urticaria 6. Erythropoietin levels were significantly higher in patients with uvula edema compared to patients without 6.
EpoR expression in non-hematopoietic tissues is shown in previous studies. A study conducted on cutaneous mast cells of subjects with or without dermatologic diseases showed the presence of soluble EpoR in secretory granules.
Other immune cells such as macrophages also can release EPO which activate mast cells in paracrine way to express EpoR. Considering the paracrine effect on mast cells, the tissue level of EPO may be high before blood levels elevated. The relationship of mast cells in different tissues and difference between tissue and blood levels of EPO need further studies.
Urticaria, angioedema, anaphylaxis cannot be differentiated via using levels of erythropoietin. However, uvula edema is correlated with higher erythropoietin levels.
