title: Isoniazid-triggered pure red cell aplasia in systemic lupus erythematosus complicated with myasthenia gravis.
abstract: A 47-year-old woman who had been treated for systemic lupus erythematosus (SLE) with myasthenia gravis (MG) was admitted to our hospital with acute onset of severe anemia after administration of isoniazid. Pure red cell aplasia (PRCA) was confirmed by elevated serum iron levels, reticulocytopenia and bone marrow aspiration showing a remarkable reduction of erythroblasts. Finally, cyclosporine A successfully improved PRCA. Although both SLE and MG have the potential complication of PRCA, we report here a case of isoniazid-triggered PRCA.
authors.affiliation: Unit of Translational Medicine, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki city, Nagasaki, 852-8501, Japan. nhideki@nagasaki-u.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Akitomo
authors.initials: A
authors.lastname: Okada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawakami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ida
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Motomura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Imanishi
authors.forename: Katsumi
authors.initials: K
authors.lastname: Eguchi
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004900:Erythroblasts; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007501:Iron / Q000097:blood; D007538:Isoniazid / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000150:complications / Q000188:drug therapy*; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D017701:Reticulocyte Count; D012156:Reticulocytes / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D007501:Iron; D007538:Isoniazid
references.citation: Clin Exp Rheumatol. 2003 Nov-Dec;21(6):759-62
references.pmid: 14740456
references.citation: Postgrad Med J. 1987 Apr;63(738):309-10
references.pmid: 3120168
references.citation: Hematology. 2005 Jun;10(3):255-9
references.pmid: 16019474
references.citation: Am J Hematol. 2005 Feb;78(2):161-3
references.pmid: 15682416
references.citation: Emerg Infect Dis. 2007 Sep;13(9):1427-8
references.pmid: 18252131
references.citation: Eur J Haematol. 2004 Dec;73(6):389-96
references.pmid: 15522059
references.citation: Haematologica. 2007 Aug;92(8):1021-8
references.pmid: 17640861
references.citation: World J Gastroenterol. 2007 Apr 7;13(13):2007-10
references.pmid: 17461508
references.citation: Blood Rev. 1996 Mar;10(1):20-8
references.pmid: 8861276
references.citation: Semin Arthritis Rheum. 2002 Feb;31(4):279-83
references.pmid: 11836661
references.citation: Jpn J Clin Oncol. 1998 Nov;28(11):696-701
references.pmid: 9861237
references.citation: Blood. 1985 Apr;65(4):789-94
references.pmid: 3919781