Normochromic normocytic anemia in a postmenopausal woman with severe osteoporosis treated with intermittent parathyroid hormone.

Intermittent exogenous parathyroid hormone (PTH) is a potent osteoanabolic agent used for the treatment of severe osteoporosis. Two molecules of recombinant PTH are commercially available: the full-length PTH (PTH 1–84) and teriparatide (PTH 1–34). We present the first report of PTH-induced mild, asymptomatic, normochromic normocytic anemia in a postmenopausal woman treated sequentially with PTH 1–84 and PTH 1–34. Anemia was more pronounced with PTH 1–84 compared to PTH 1–34 and was reversed with each regimen discontinuation. We suggest monitoring of hematocrit and hemoglobin in PTH-treated patients, especially when PTH 1–84 is used.