Pure red cell aplasia and thymoma: demonstration of persisting inhibition of erythropoiesis after thymectomy and resolution after immune suppressive treatment.
A 61 year-old woman presented with general malaise, hair loss, pure red cell aplasia (PRCA) and thymoma: no growth of erythropoietic colonies in vitro (BFU-E) was observed in the presence of her own serum. The thymoma was removed: after the operation no improvement of her anaemic condition was observed and colony growth was very poor, although T-depleted narrow preparations showed a modest BFU-E formation in autologous serum. Following treatment with azathioprine, a complete recovery was seen, associated with normal BFU-E formation in vitro. This observation suggests that a complex inhibition of erythropoiesis may operate in PRCA involving both humoral and cellular factors; thymectomy alone may not be sufficient to restore haemopoiesis, but has to be followed by immune suppressive treatment.
D000917:Antibody Formation / Q000187:drug effects; D001379:Azathioprine / Q000494:pharmacology; D001854:Bone Marrow Cells; D003114:Colony-Forming Units Assay; D004920:Erythropoiesis / Q000187:drug effects*; D005260:Female; D006412:Hematopoietic Stem Cells; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000276:immunology / Q000494:pharmacology*; D008212:Lymphocyte Depletion; D008875:Middle Aged; D012010:Red-Cell Aplasia, Pure / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology; D013934:Thymectomy; D013945:Thymoma / Q000150:complications / Q000276:immunology* / Q000601:surgery
D007166:Immunosuppressive Agents; D001379:Azathioprine