title: A case of pure red cell aplasia complicated by Evans syndrome.
abstract: A 33-year-old woman complaining of severe anemia was admitted to our hospital for polyclonal hyperglobulinemia. She was diagnosed with pure red cell aplasia (PRCA) associated with Evans syndrome. Initially, the presence of human parvovirus B19 (HPV B19) IgM appeared to indicate that the cause of PRCA was HPV B19 infection. Evans syndrome improved with steroid therapy, but PRCA was refractory. Cyclosporine was administered; consequently, the patient markedly recovered from PRCA and was discharged. PRCA complicated by Evans syndrome occurred during the course of polyclonal hyperglobulinemia. The most direct etiology for the onset of PRCA was unclear; however, immunological disorders such as polyclonal hyperglobulinemia, in addition to HPV B19 infection, may have been partly responsible for the etiology of PRCA.
authors: Division of Rheumatology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan. yasuhiko@f-h.nir.jp
authors: Yasuhiko
authors: Y
authors: Toyokawa
authors: Isamu
authors: I
authors: Kingetsu
authors: Chiho
authors: C
authors: Yasuda
authors: Jun
authors: J
authors: Yasuda
authors: Ken
authors: K
authors: Yoshida
authors: Daitaro
authors: D
authors: Kurosaka
authors: Akio
authors: A
authors: Yamada
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000276:immunology; D003298:Coombs Test; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005916:Globulins / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D010322:Parvoviridae Infections / Q000150:complications* / Q000276:immunology; D016732:Parvovirus B19, Human / Q000276:immunology*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications; D012010:Red-Cell Aplasia, Pure / Q000150:complications*; D013256:Steroids / Q000627:therapeutic use; D013577:Syndrome
chemical_list: D005916:Globulins; D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine