A patient with acquired pure red cell aplasia showing a positive antiglobulin test and the presence of inhibitor against erythroid precursors.
A 66-year-old Japanese man developed severe anemia and erythroid hypoplasia in bone marrow without any significant underlying disease. The results of an antiglobulin test were strongly positive, and serum erythropoietin (Epo) was high. The patient was diagnosed as having acquired pure red cell aplasia (PRCA) and was treated with steroids. Anemia was subsided by reticulocyte production in parallel with a decrease in the titer of antiglobulin test and the level of Epo. We studied the immunological mechanism directed against erythroid cells in vitro by using the patient's serum. In vitro analysis indicated the presence of an inhibitor of erythroid precursors at onset, and its disappearance at remission, suggesting the presence of inhibitor against erythroid precursors.
Division of Hematology, Institute of Clinical Medicine, University of Tsukuba.
Yasushi
Y
Okoshi
Shigehiko
S
Imagawa
Masato
M
Higuchi
Chikashi
C
Yoshida
Seiichi
S
Shimizu
Harumi Y
HY
Mukai
Takuya
T
Komeno
Yuichi
Y
Hasegawa
Haruhiko
H
Ninomiya
Hiroshi
H
Kojima
Toshiro
T
Nagasawa
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001856:Bone Marrow Examination; D003298:Coombs Test / Q000379:methods*; D015672:Erythroid Precursor Cells / Q000276:immunology*; D004921:Erythropoietin / Q000097:blood; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000276:immunology* / Q000503:physiopathology; D014407:Tumor Cells, Cultured
D000893:Anti-Inflammatory Agents; D004921:Erythropoietin; D011239:Prednisolone; D008775:Methylprednisolone