Erythropoietin 

Updated: Dec 05, 2014
  • Author: Georges Elhomsy, MD, ECNU, FACE; Chief Editor: Eric B Staros, MD  more...
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Reference Range

Erythropoietin testing, in combination with other tests, can be used to differentiate polycythemia vera from secondary polycythemia. It can also help differentiate between appropriate and inappropriate secondary polycythemia.

The reference ranges of erythropoietin vary by age, as follows: [1]

  • Adults: 4.1-19.5 mU/mL
  • Infants aged 3 weeks to 2 months: 5-13 mU/mL
  • Children aged 3 months to 16 years: 9-28 mU/mL
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Interpretation

Elevated erythropoietin levels are associated with the following:

Suppressed erythropoietin levels are associated with the following:

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Collection and Panels

Specimen type: Serum

Patient instruction: No need for fasting

Collection tube: Red-top tube or gel-barrier tube

Unacceptable conditions: Grossly hemolyzed specimens

Specimen preparation: Separate serum from cells and transfer to transport tube

Storage/transport temperature: Refrigerated

Stability: Refrigerated, 7 days; frozen, 2 weeks

Panels: None

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Background

Description

Erythropoietin is produced by the liver during fetal life. After birth, the kidneys constitute the major source of production. Erythropoietin, a member of class 1 cytokines, is a 30.4-kDa glycoprotein composed of 4 chains of carbohydrate and a protein chain composed of 193 amino acids that undergo a cleavage process, resulting in the production of mature erythropoietin (165 amino acids).

Erythropoietin is secreted by fibroblasts in the renal cortex. These cells possess specific regulatory mechanisms, called hypoxia-inducible factors (HIFs), which, under hypoxic conditions, stimulate the production of erythropoietin, which stimulates the production of erythrocytes.

Indications/Applications

Erythropoietin testing, in combination with other tests, can be used to differentiate polycythemia vera from secondary polycythemia. It can also help differentiate between appropriate and inappropriate secondary polycythemia.

In some conditions, erythropoietin testing can be used in the assessment and differentiation of anemia, especially in patients receiving erythropoietin replacement therapy with an inadequate response.

Considerations

Erythropoietin has been used as a doping agent, since it can improve performance by improving tissue oxygenation.

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