title: Mycophenolate mofetil-induced erythroid hypoplasia in a patient with systemic lupus erythematosus.
abstract: Anaemia is prevalent in patients with systemic lupus erythematosus (SLE). The anaemia is often a consequence of the disease itself but may also be secondary to drug treatments. Mycophenolate mofetil (MMF) is increasingly used in the management of patients with SLE and its associated anaemia. We describe the case of a 19-year-old girl, who presented acutely with SLE and renal involvement. Her disease was controlled with immunosuppression but she later developed severe transfusion-dependent anaemia. Several causes were considered before a bone marrow biopsy led to the diagnosis of erythroid hypoplasia. In the absence of clinical or laboratory markers of active lupus, MMF was implicated as the cause. Its discontinuation led to a rapid and sustained correction of the anaemia. Red cell aplasia linked to the use of MMF is uncommon and the manufacturers are aware of fewer than 50 cases. This is the first case report of evolving red cell aplasia induced by MMF in SLE.
authors.affiliation: Department of Rheumatology, St Georges Healthcare NHS Trust, London, UK. iamteresadoherty@gmail.com
authors.forename: T
authors.initials: T
authors.lastname: Doherty
authors.forename: S K
authors.initials: SK
authors.lastname: Austin
authors.forename: B
authors.initials: B
authors.lastname: Newell
authors.forename: P D W
authors.initials: PD
authors.lastname: Kiely
mesh_terms: D000740:Anemia / Q000209:etiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D012010:Red-Cell Aplasia, Pure / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid