[A case of systemic lupus erythematosus with pure red cell aplasia possibly caused by persistent infection of human parvovirus B 19].
We reported a 68-old female who was diagnosed to have systemic lupus erythematosus 18 years ago. She had been well under 5 mg of prednisolone until 1995, when she felt severe shortness of breath. Laboratory examinations disclosed severe anemia accompanying mild thrombocytopenia. Bone marrow aspiration revealed a complete absence of erythroid progenitor cells. She was diagnosed to have pure red cell aplasia (PRCA) as well as antiphospholipid syndrome. A judicious use of methylprednisolone including pulse therapy resulted in a prompt resolution of anemia as well as thrombocytopenia and the dose of corticosteroid was tapered successfully thereafter. Persistent infection of HPV B 19 in the patient with inactive SLE was considered as a main cause of PRCA because not only IgG-HPV B 19 antibody but viral DNA was demonstrated in her serum at the time of admission. The relationship between PRCA and anti-phospholipid syndrome in this patient was also noted.
Mitsunaka
H
H
First Department of Internal Medicine, Kagawa Medical University.
Tokuda
M
M
Takahara
J
J
Matoba
K
K
Miyawaki
S
S
D000368:Aged; D016736:Antiphospholipid Syndrome / Q000209:etiology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008775:Methylprednisolone / Q000008:administration & dosage; D009894:Opportunistic Infections / Q000150:complications*; D010322:Parvoviridae Infections / Q000150:complications* / Q000175:diagnosis; D016732:Parvovirus B19, Human; D011239:Prednisolone / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome
D011239:Prednisolone; D008775:Methylprednisolone