title: Pure red cell aplasia associated with cytomegalovirus and Epstein-Barr virus infection in seven cases of Chinese children.
abstract: Pure red cell aplasia (PRCA) associated with cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infection is uncommon. Here, we describe the clinical features and management of seven cases of Chinese children with PRCA associated with viral infections. The patients presented  with pallor on admission. Blood cell counts and marrow smears showed anemia, reticulocytopenia, and aplasia of erythroblasts. Serological investigation and DNA polymerase chain reactions for CMV were positive in four patients and those tests for EBV were positive in other three patients. All  patients received blood transfusion, corticosteroids treatment, and ganciclovir injection. Two patients had a complete response and one had a partial response after the treatments. The other three patients had a complete response to second-line therapies, including high-dose methylprednisolone,  cyclosporin A, and intravenous immunoglobulin. Only one patient had no response to the therapies. Our results indicated that it might be important to combine immunosuppressive drugs with an antiviral drug in the management of PRCA associated with CMV and EBV infection.
authors: Department of Pediatrics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Lu-Hong
authors: LH
authors: Xu
authors: Jian-Pei
authors: JP
authors: Fang
authors: Wen-Jun
authors: WJ
authors: Weng
authors: Ke
authors: K
authors: Huang
authors: Hai-Xia
authors: HX
authors: Guo
authors: Yong
authors: Y
authors: Liu
authors: Jin-Hua
authors: JH
authors: Zhang
mesh_terms: D001803:Blood Transfusion; D002675:Child, Preschool; D002681:China; D016572:Cyclosporine / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000097:blood*; D020031:Epstein-Barr Virus Infections / Q000097:blood*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008775:Methylprednisolone / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000097:blood / Q000188:drug therapy / Q000628:therapy / Q000821:virology*
chemical_list: D016756:Immunoglobulins, Intravenous; D016572:Cyclosporine; D008775:Methylprednisolone