title: Rapidly progressive autoimmune pancytopenia successfully treated with steroids.
abstract: A 73-year-old woman was admitted to our hospital because of pancytopenia. Bone marrow aspiration showed increased cellularity with no dysplastic change. Laboratory tests revealed increased reticulated erythrocytes and reticulated platelets, positive direct Coombs test, and hemolysis. These findings led to the diagnosis of Evans syndrome. Relatively decreased mature neutrophils in the bone marrow aspirate raised the possibility of autoimmune neutropenia. Antineutrophil antibody was detected by the 6 cell-lineage immunofluorescence test, consistent with the diagnosis of autoimmune neutropenia. The patient had no underlying diseases, and was therefore considered to have idiopathic autoimmune pancytopenia. Due to rapid progression of the disease, prednisolone was administered at an initial dose of 0.5 mg/kg per day and the pancytopenia improved promptly.
authors.affiliation: Department of Hematology, Osaka Red Cross Hospital.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Mitani
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Okubo
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Nishi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Kohei
authors.initials: K
authors.lastname: Tada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatanaka
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Naoya
authors.initials: N
authors.lastname: Ukyo
authors.forename: Chisato
authors.initials: C
authors.lastname: Mizutani
authors.forename: Kazunori
authors.initials: K
authors.lastname: Imada
mesh_terms: D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D001706:Biopsy; D019070:Cell Lineage; D018450:Disease Progression; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D010198:Pancytopenia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone