title: First case report of acquired pure red cell aplasia associated with micafungin.
abstract: A 70-year-old Japanese man with chronic kidney disease under treatment with oral prednisolone for organizing pneumonia developed pulmonary aspergilloma. The patient was started on micafungin (MCFG), with no addition of any other new drug. About 5 weeks later, aggravation of his normocytic anemia associated with a low reticulocyte count was observed. Bone marrow puncture and biopsy revealed intense hypoplasia of the erythroblasts. As there was no evidence of malignancy, human parvovirus B19 infection, autoimmune diseases or hemorrhage, the patient was diagnosed as having acquired pure red cell aplasia (PRCA). The anemia improved along with an increase of the reticulocyte count to the normal level within 12 weeks of discontinuation of the MCFG therapy. The patient showed no evidence subsequently of any recurrence of the normocytic normochromic anemia or relapse of the PRCA. This is the first reported case of PRCA associated with MCFG.
authors.affiliation: Department of Internal Medicine, Kawasaki Social Insurance Hospital, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Yoshida-Hiroi
authors.forename: Masayuki
authors.initials: M
authors.lastname: Koizumi
authors.forename: Reiko
authors.initials: R
authors.lastname: Oka
authors.forename: Aki
authors.initials: A
authors.lastname: Mitsuda
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiroi
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects*; D001853:Bone Marrow / Q000473:pathology; D018549:Cryptogenic Organizing Pneumonia / Q000188:drug therapy; D054714:Echinocandins / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D055666:Lipopeptides / Q000009:adverse effects*; D008297:Male; D000077551:Micafungin; D011239:Prednisolone / Q000009:adverse effects; D055732:Pulmonary Aspergillosis / Q000188:drug therapy; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000139:chemically induced* / Q000473:pathology
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D007166:Immunosuppressive Agents; D055666:Lipopeptides; D011239:Prednisolone; D000077551:Micafungin