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Dyserythropoiesis and erythroblast‐phagocytosis preceding pure red cell aplasia
Author(s) -
Keefer Michael J.,
Solanki Dilip L.
Publication year - 1988
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830270212
Subject(s) - erythroblast , pure red cell aplasia , erythropoiesis , phagocytosis , anemia , aplasia , immunology , bone marrow , reticulocyte , medicine , biology , biochemistry , messenger rna , gene
A 50‐year‐old woman with typical acquired primary pure red cell aplasia (PRCA) was successfully treated with prednisone. A later relapse was preceded by a period of ineffective erythropoiesis characterized by a reticulocyte response inappropriately low for the degree of anemia, serum iron of 189 üg/dl, total iron‐binding capacity (TIBC) of 213 μ/g/dl, and erythroid hyperplasia. In addition there was marked dyserythropoiesis and erythroblast‐phagocytosis. One month later, bone marrow examination showed classic PRCA. This rarely reported evolutionary stage of PRCA has several implications: 1) it suggests antibody induced erythroblast cytotoxicity as one mechanism of PRCA; 2) at a particular time in the development of PRCA there is potential for misdiagnosis as primary refractory anemia (PRA); and 3) some cases of PRA with similar morphologic and laboratory findings may be pathogenetically related to PRCA and may benefit from evaluation for immune‐mediated suppression of erythropoiesis.