Darbepoetin therapy for anaemia and orthostatic presyncope and palpitations in a woman with beta-thalassemia minor and possible postural orthostatic tachycardia syndrome

β-thalassemia minor is associated with high rates of anaemia developing in pregnancy, possibly related to a blunted erythropoietin response. Anaemia with an inadequate erythropoietin response has been demonstrated in non-pregnant individuals with autonomic neuropathy with normal renal function. A case of mild anaemia in pregnancy with severe orthostatic symptoms in a woman with β-thalassemia minor and possible postural orthostatic tachycardia syndrome, with rapid resolution of symptoms and improvement in anaemia with darbepoetin therapy is described. The potential role of erythropoietin-stimulating agents in the management of symptoms in pregnancy-related anaemia in thalassemia minor is discussed.