title: Thrombocytopenia and Anemia with Anti-c-Mpl antibodies Effectively Treated with Cyclosporine in a Patient with Rheumatoid Arthritis and Chronic Renal Failure.
abstract: A 61-year-old woman with rheumatoid arthritis who was undergoing hemodialysis for end-stage renal failure was transferred to our hospital due to severe thrombocytopenia and anemia. A bone marrow biopsy showed the complete absence of megakaryocytes and erythroblasts. Cyclosporine treatment resulted in the improvement of her megakaryocyte and erythroblast levels, and a decrease in her serum level of anti-c-Mpl (thrombopoietin receptor) antibodies. After this initial improvement, her anemia progressively worsened, despite the continuous administration of immunosuppressive therapy with cyclosporine. Her platelet and leukocyte counts remained stable. This is the first report of a probable case of anti-c-Mpl antibody-associated pure red cell aplasia and acquired amegakaryocytic thrombocytopenic purpura.
authors.affiliation: Department of Hematology and Oncology, Oji General Hospital, Japan.
authors.forename: Akari
authors.initials: A
authors.lastname: Hashimoto
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kanisawa
authors.forename: Akihito
authors.initials: A
authors.lastname: Fujimi
authors.forename: Chisa
authors.initials: C
authors.lastname: Nakajima
authors.forename: Naotaka
authors.initials: N
authors.lastname: Hayasaka
authors.forename: Shota
authors.initials: S
authors.lastname: Yamada
authors.forename: Toshinori
authors.initials: T
authors.lastname: Okuda
authors.forename: Shinya
authors.initials: S
authors.lastname: Minami
authors.forename: Natsumi
authors.initials: N
authors.lastname: Yamauchi
authors.forename: Sari
authors.initials: S
authors.lastname: Iwasaki
authors.forename: Akira
authors.initials: A
authors.lastname: Suzuki
authors.forename: Junji
authors.initials: J
authors.lastname: Kato
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001853:Bone Marrow / Q000473:pathology; D016572:Cyclosporine / Q000627:therapeutic use*; D004900:Erythroblasts / Q000187:drug effects / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007518:Isoantibodies / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008533:Megakaryocytes / Q000187:drug effects / Q000276:immunology; D008875:Middle Aged; D053628:Receptors, Thrombopoietin / Q000037:antagonists & inhibitors*; D012010:Red-Cell Aplasia, Pure / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects*; D013921:Thrombocytopenia / Q000188:drug therapy* / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents; D007518:Isoantibodies; D053628:Receptors, Thrombopoietin; C051138:anti-c antibody; C082218:MPL protein, human; D016572:Cyclosporine