title: [Angioimmunoblastic T-cell lymphoma accompanied by pure red cell aplasia].
abstract: A 71-year-old woman was admitted in December 2002 because of lymphadenopathy, hepatosplenomegaly and pleural effusion. She had severe anemia with hemoglobin 5.9 g/dl and a reticulocyte count of 1% per hundred. Direct/indirect Coombs tests and anti-double stranded DNA antibody were positive, her serum CH50 level was reduced and an increase in serum LDH isoenzyme 3 was observed. Bone marrow aspiration showed an almost total absence of erythroblasts and no pathological cell proliferation. The diagnosis of angioimmunoblastic T-cell lymphoma (AILT) was made based on the lymph node histological findings. Proliferation of arborizing small vessels with hyperplastic endothelium and infiltration of atypical T-lymphocytes were observed. After combination chemotherapy (THP-COP), remission was achieved in both the pure red cell aplasia (PRCA) and AILT. Remission was also accompanied by normalization of the Coombs tests, suggesting that autoimmune mechanisms in AILT may contribute to the development of PRCA.
authors.affiliation: First Department of Internal Medicine, University of Occupational and Environmental Health.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Mizobe
authors.forename: Junichi
authors.initials: J
authors.lastname: Tsukada
authors.forename: Takehiro
authors.initials: T
authors.lastname: Higashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iwashige
authors.forename: Takanori
authors.initials: T
authors.lastname: Ota
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawano
authors.forename: Ayumu
authors.initials: A
authors.lastname: Kubota
authors.forename: Ai
authors.initials: A
authors.lastname: Matsuura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Morimoto
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ogawa
authors.forename: Yoko
authors.initials: Y
authors.lastname: Toda
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Tanaka
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D003298:Coombs Test; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007119:Immunoblastic Lymphadenopathy / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage; D012010:Red-Cell Aplasia, Pure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone