Erythropoietin Service (SAS)

Purpose of the test

The measurement of serum erythropoietin (EPO) is a useful diagnostic tool in the differential diagnosis of anaemia. Most anaemic patients have appropriately elevated serum EPO that is dependent on the degree and type of anaemia. Aplastic anaemia, haemolytic anaemia and anaemia due to iron deficiency results in increased levels of serum EPO. Serum EPO in patients with anaemia associated with chronic renal failure is usually inappropriate due to reduced EPO production by the kidney.

An important application is the differentiation between primary and secondary polycythaemia. Patients with polycythaemia rubra vera (primary polycythaemia) typically present with normal or subnormal serum EPO whereas those with secondary polycythaemia brought on by chronic hypoxaemia, as in cyanotic congestive heart failure or chronic obstructive pulmonary disease, present with elevated levels.

The acquired JAK2 mutation V617F is associated with polycythaemia and related myeloproliferative disorders. Please use this link for further details of our JAK2 test service http://kingspath.co.uk/specialist.php?id=haematology&gid=4&d=146

Treatment with recombinant EPO has been shown to be useful in disease states such as anaemia of chronic renal failure, and of inflammatory bowel disease, multiple myeloma and AIDS. Monitoring serum EPO levels reduces toxicity and ensures adequate therapeutic concentrations are achieved.

The assay is a solid phase chemiluminescence immunometric assay for use on the DPC Immulite 2000 analyser. The assay is performed twice weekly and interpretation of the results is given where adequate clinical information is provided.

We participate in a pilot EQA scheme for EPO run by UKNEQAS for Haematinics.

Reference Range

The normal range for serum erythropoietin is 5.0 - 25 U/L for an individual with a haemoglobin within limits.

Download the EPO request form below for further information on correlation data between serum erythropoietin and haemoglobin levels for results interpretation.

Sample Requirements

Collect blood in a tube containing no additives and allow to clot before centrifuging.

Storage and Transport

Serum may be stored refrigerated at 4°C for up to 7 days, for longer storage it is recommended that samples should be kept at -20°C, repeat freeze thawing should be avoided. External samples can be transported unfrozen by 1st class post or courier to the laboratory. A minimum volume of 500µl of serum is required for analysis.

If possible, please complete the request form attached and send as a hard copy (do not send electronically) with the sample. This will ensure all relevant information is available and will aid us in processing your test.

PDF Request Form

Download Erythropoietin Service (SAS) Request Form

Turnaround Time

3 - 7 days

Price

Price available on application - please contact adrian.turner@kch.nhs.uk. Discounts could be available for significant workloads.

Contacts

Dr Joanne Marsden Tel: 020 3299 3856. e-mail: joanne.marsden@kch.nhs.uk

References

Marsden JT. (2006) Erythropoietin – measurement and clinical applications. Ann Clin Biochem 43: 97-104

Marsden JT. Day P, Ellis R, Marwah S, Savage G, Sinclair C (2006) A sample distribution programme for erythropoietin. Clin Lab Haem 28: 228-232

Campbell PJ, Scott LM, Buck G, Wheatley K, East C, Marsden JT et al (2005) Definition of subtypes of essential thrombocythaemia and relation to polycythaemia vera base on JAK2V617F mutation status: a prospective study. Lancet 366: 1945-53

Winkler AS, Blair D, Marsden JT, Peters TJ, Wessely S, Cleare AJ (2004) Autonomic function and serum erythropoietin levels in chronic fatigue syndrome. J Psycosomat Res 56: 179-83

Winkler AS, Peters TJ, Marsden JT, Deacon AC, Chandler G, Macdougall IC (2003) Erythropoietin treatment in the neuropsychiatric porphyrias. Clin Chim Acta 338: 61-6

Winkler AS, Marsden J, Deacon A, Wilson S, Chandler G, Macdougall IC, Peters TJ (2002) Serum erythropoietin levels may be inappropriately low in the acute neuropsychiatric porphyrias. Clin Chim Acta 317: 93-100

Messinezy M, Westwood NB, El-Hemaidi I, Marsden JT, Sherwood RA, Pearson TC. (2002) Serum erythropoietin values in the erythrocytoses and in primary thrombocythaemia. Br J Haematol 117: 47-53

Winkler AS, Marsden J, Parton M, Watkins PJ, Chaudhuri KR (2001) Erythropoietin deficiency and anaemia in multiple system atrophy. Movement Disorders 16: 233-39

Bosman DR, Winkler AS, Marsden JT, Macdougall IC, Watkins PJ (2001) Anaemia with erythropoietin deficiency occurs early in diabetic retinopathy. Diabetes Care 24: 495-9

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