Pregnancy complicated with pure red cell aplasia: a case report.
A 31-year-old Japanese pregnant woman had no remarkable previous medical and family histories except for artificial abortion in 1993. A full-term normal infant was subsequently delivered in 1998. In this pregnancy, she began to experience general fatigability with a hemoglobin concentration of 8.5 g/dl at 19 weeks of gestation. Although she had been treated with intravenous iron, the hemoglobin decreased to 6.0 g/dl. She was referred to our hospital at 34 weeks of gestation. The laboratory data were as follows on this admission; hemoglobin 5.1 g/dl, RBC 128 x 10(4)/l, reticulocytes 1.1%, WBC 7.1 x 10(9)/l, platelet count 229 x 10(9)/l, folic acid 5.6 ng/ml, serum vitamin B12 200 pg/ml, ferritin 184 ng/ml, parvovirus B19 (-). A bone marrow aspiration revealed normal granulopoiesis and megakaryocytes, but almost complete absence of erythropoietic precursors. A diagnosis of pure red cell aplasia was made due to these findings. Treatment with prednisone (50 mg/day) and blood transfusion was started before delivery. She was delivered transvaginally at 37 weeks of gestation. The neonate was a normal female infant without anemia (hemoglobin 17.9 g/dl) and the 1 minute Apgar score was 8. Her hemoglobin level rose to 12.1 g/dl spontaneously two weeks after delivery.
Makino
Yasuo
Y
Department of Obstetrics and Gynecology, School of Medicine, Fukuoka University, Fukuoka, Japan. makino1208@nifty.com
Nagano
Mitsuyuki
M
Tamura
Kazuo
K
Kawarabayashi
Tatsuhiko
T
D000328:Adult; D001803:Blood Transfusion; D001856:Bone Marrow Examination; D005260:Female; D005865:Gestational Age; D006801:Humans; D007564:Japan; D011241:Prednisone / Q000627:therapeutic use; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis*; D011256:Pregnancy Outcome; D012010:Red-Cell Aplasia, Pure / Q000175:diagnosis* / Q000628:therapy
D011241:Prednisone