Combined pure red cell aplasia and autoimmune hemolytic anemia in systemic lupus erythematosus with anti-erythropoietin autoantibodies.
A 42-year-old woman with systemic lupus erythematosus was admitted to our hospital because of severe anemia. Her bone marrow was almost normocellular and erythroblasts were nearly absent. Laboratory data showed elevated levels of lactate dehydrogenase and positive findings on Coombs' tests. On the basis of these findings, her anemia was diagnosed as the overlap of pure red cell aplasia with autoimmune hemolytic anemia. Radioimmunoprecipitation assay revealed that her serum was positive for anti-erythropoietin antibodies before therapy. Furthermore, the autoantibodies inhibited proliferation of an erythropoietin-dependent cell line in a dose-dependent manner. Immunosuppressive treatment improved the anemia accompanied with disappearance of the autoantibodies.
Hara
Akinori
A
Department of Disease Control and Homeostasis, Graduated School of Medical Science, Kanazawa University, Kanazawa, Japan.
Wada
Takashi
T
Kitajima
Shinji
S
Toyama
Tadashi
T
Okumura
Toshiya
T
Kitagawa
Kiyoki
K
Iwata
Yasunori
Y
Sakai
Norihiko
N
Furuichi
Kengo
K
Higuchi
Masato
M
Kaneko
Shuichi
S
D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D000918:Antibody Specificity; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D001853:Bone Marrow / Q000473:pathology; D002455:Cell Division / Q000187:drug effects; D002460:Cell Line / Q000187:drug effects; D015672:Erythroid Precursor Cells / Q000187:drug effects; D004921:Erythropoietin / Q000276:immunology*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008180:Lupus Erythematosus, Systemic / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D008775:Methylprednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology
D001323:Autoantibodies; D007166:Immunosuppressive Agents; D004921:Erythropoietin; D011239:Prednisolone; D008775:Methylprednisolone