Successful treatment of pure red cell aplasia with plasmapheresis in a patient with systemic lupus erythematosus.
Pure red cell aplasia (PRCA) is a rare cause of anemia associated with systemic lupus erythematosus (SLE), and fewer than 20 cases have been reported. The development of PRCA may be mediated by an autoimmune mechanism which is supported by the presence of antibodies that impair various stages and mechanisms of erythropoiesis, by the association with immunological disorders or lymphoma, and by a favorable response to immunosuppressive drugs, antilymphocyte globulin, thymectomy, and splenectomy. However, these therapies have not been successful in all patients with PRCA. We report our experience with a 31-year-old female patient with SLE who developed PRCA that did not respond to immunosuppressive therapies. However, complete normalization of erythropoiesis was achieved after the removal of the autoantibodies by plasmapheresis, and the patient has now maintained a normal hemoglobin level for more than eight months. We suggest that plasmapheresis might be tried in the treatment of PRCA cases before other more aggressive therapies are commenced.
Choi
Bo Geum
BG
Division of Rheumatology, Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, #634-18, Keumam-Dong, Duckjin-Gu, Chonju, Chonbuk 561-712, Korea.
Yoo
Wan Hee
WH
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D004920:Erythropoiesis; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D010956:Plasmapheresis; D012010:Red-Cell Aplasia, Pure / Q000150:complications* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*