Open AccessPure red cell aplasia following autoimmune hemolytic anemia: An enigma
Author(s) -
Manideepa Saha,
Sayantan Ray,
Saratsasi Kundu,
Prantar Chakrabarti
Publication year - 2013
Publication title -
journal of postgraduate medicine/journal of postgraduate medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.405
H-Index - 52
eISSN - 0972-2823
pISSN - 0022-3859
DOI - 10.4103/0022-3859.109495
Subject(s) - medicine , pure red cell aplasia , autoimmune hemolytic anemia , azathioprine , hemolysis , anemia , bone marrow examination , prednisolone , bone marrow , immunology , hemolytic anemia , coombs test , gastroenterology , disease , antibody
A 26-year-old previously healthy female presented with a 6-month history of anemia. The laboratory findings revealed hemolytic anemia and direct antiglobulin test was positive. With a diagnosis of autoimmune hemolytic anemia (AIHA), prednisolone was started but was ineffective after 1 month of therapy. A bone marrow trephine biopsy revealed pure red cell aplasia (PRCA) showing severe erythroid hypoplasia. The case was considered PRCA following AIHA. This combination without clear underlying disease is rare. Human parvovirus B19 infection was not detected in the marrow aspirate during reticulocytopenia. The patient received azathioprine, and PRCA improved but significant hemolysis was once again documented with a high reticulocyte count. The short time interval between AIHA and PRCA phase suggested an increased possibility of the evolution of a single disease.