Intravenous immunoglobulins in autoimmune- or parvovirus B19-mediated pure red-cell aplasia.
Pure red-cell aplasia (PRCA) is defined as the absence of mature erythroid precursors in a bone marrow that otherwise exhibit normal cellularity. Acquired PRCA may occur in association with neoplasms (such as lymphoproliferative disorders), thymoma, autoimmune disorders, pregnancy, or as a consequence of chronic human parvovirus B19 (B19) infection in an immunologically incompetent host. PRCA may also develop after exposure to drugs (erythropoietin or tacrolimus). PRCA of autoimmune origin was first treated successfully with intravenous immunoglobulins (IVIg) more than 20 years ago. Since then, B19-associated PRCA in solid-organ transplant recipients and in human immunodeficiency virus (HIV)-infected patients has also been successfully treated with IVIg. Routine maintenance therapy is probably not indicated in HIV-infected patients with CD4+ counts above 300/microL, whereas repeated infusions might be necessary if CD4+ count is below 80.
Department of Internal Medicine, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris and Université Paris V, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France. luc.mouthon@cch.ap-hop-paris.fr
Luc
L
Mouthon
Loïc
L
Guillevin
Zera
Z
Tellier
D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010322:Parvoviridae Infections / Q000188:drug therapy* / Q000276:immunology; D016732:Parvovirus B19, Human / Q000276:immunology; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy* / Q000276:immunology / Q000821:virology
D016756:Immunoglobulins, Intravenous