title: Clinical characteristics and outcomes of 11 patients with pure red cell aplasia at a single institution over a 13-year period.
abstract: OBJECTIVE
  Pure red cell aplasia (PRCA) is a rare clinical entity characterized by anemia due to severe suppression of erythroid precursors, where the other cell lineages in the bone marrow remain morphologically normal. A standard treatment has not yet been established for PRCA due to the rarity of this condition. Recently, however, the administration of either cyclosporine (CSP) or prednisolone (PSL) has been reported to be an effective treatment for PRCA.
  
  
  METHODS
  To clarify the clinical characteristics of PRCA, 11 PRCA cases were retrospectively analyzed over a 13-year period at our institution. Since acute PRCA was found to be self-limiting, we administered the immunosuppressive treatment of CSP or PSL after providing supportive care for 4 weeks.
  
  
  RESULTS
  The causes of PRCA were as follows: idiopathic (3), acute parvovirus infection (1), chronic parvovirus infection (3), thymic tumor (3), and end-stage renal disease with hemodialysis (1). Complete remission (CR) was achieved for 4 of the 5 patients treated with CSP, for 2 of the 3 patients with chronic parvovirus infection treated by immunoglobulin (Ig), and for all 3 patients treated with PSL. During the follow-up periods, 4 of the 11 patients relapsed. Complete remission was achieved a second time in all 4 cases by therapies that were more intensive and had longer administration periods than those provided during initial treatment. Consequently, 9 of the 11 patients were still alive (80%) after 5 years.
  
  
  CONCLUSIONS
  Depending on the cause of the PRCA, treatment with CSP, PSL, or Ig was found to be effective in most PRCA cases.
authors.affiliation: Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kawano
authors.forename: Yuri
authors.initials: Y
authors.lastname: Nagahiro
authors.forename: Shuro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Daisuke
authors.initials: D
authors.lastname: Himeji
authors.forename: Naoko
authors.initials: N
authors.lastname: Yokota-Ikeda
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Uezono
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Shimao
authors.forename: Shigeyoshi
authors.initials: S
authors.lastname: Makino
authors.forename: Kazuya
authors.initials: K
authors.lastname: Shimoda
authors.forename: Akira
authors.initials: A
authors.lastname: Ueda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010322:Parvoviridae Infections / Q000150:complications; D011239:Prednisolone / Q000627:therapeutic use; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D013953:Thymus Neoplasms / Q000150:complications; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone