Journal List > Korean J Hematol > v.42(2) > 1032714

Kim, Lee, Kim, Kang, Ju, Kang, and Lee: A Case of Pure Red Cell Aplasia Associated with Hashimoto Disease

Abstract

Pure red cell aplasia (PRCA) is a rare hematologic disorder characterized by anemia, reticulocytopenia in the blood and isolated severe erythroblastopenia with no abnormalities of the granulopoiesis and mega-karyopoiesis in the bone marrow. Acquired PRCA has been reported in association with various autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis, mixed connective tissue disease and Sjögren's syndrome. We report here on a case of PRCA associated with Hashimoto disease (without any other autoimmune disease) which, to the best of our knowledge, has not been previously reported in Korean and English literatures. Our patient was treated with levothyroxine alone without other immunosuppressive agents and her hemoglobin concentration and hematocrit values returned to normal.

REFERENCES

1). Fisch P., Handgretinger R., Schaefer HE. Pure red cell aplasia. Br J Haematol. 2000. 111:1010–22.
crossref
2). Rodrigues JF., Harth M., Barr RM. Pure red cell aplasia in rheumatoid arthritis. J Rheumatol. 1988. 15:1159–61.
3). Julkunen H., Jantti J., Pettersson T. Pure red cell aplasia in mixed connective tissue disease. J Rheumatol. 1989. 16:1385–6.
4). Ibkhatra S., Jacobsson L., Manthorpe R. The association of pure red cell aplasia and primary Sjogren's syndrome. Clin Exp Rheumatol. 1997. 15:119–20.
5). Dessypris EN. Pure red cell aplasia. Hoffman R, Benz EJ, Shattil SJ, editors. Hematology: basic principles and practice. 4th ed.Philadelphia, USA: Elsevier Inc.;2005. p. 429–39.
crossref
6). Yamada O. Clonal T cell proliferation in patients with pure red cell aplasia. Leuk Lymphoma. 1999. 35:69–82.
crossref
7). Handgretinger R., Geiselhart A., Moris A, et al. Pure red-cell aplasia associated with clonal expansion of granular lymphocytes expressing killer-cell inhibitory receptors. N Engl J Med. 1999. 340:278–84.
crossref
8). Myers TJ., Bower BF., Hild DH. Pure red cell aplasia and the syndrome of multiple endocrine gland in-sufficiency. Am J Med Sci. 1980. 280:29–34.
9). Francis DA. Pure red-cell aplasia: association with systemic lupus erythematosus and primary autoimmune hypothyroidism. Br Med J (Clin Res Ed). 1982. 284:85.
crossref
10). Heck LW., Alarcon GS., Ball GV, et al. Pure red cell aplasia and protein-losing enteropathy in a patient with systemic lupus erythematosus. Arthritis Rheum. 1985. 28:1059–61.
crossref
11). Franzen P., Friman C., Pettersson T., Fyhrquist F., Ruutu T. Combined pure red cell aplasia and primary autoimmune hypothyroidism in systemic lupus erythematosus. Arthritis Rheum. 1987. 30:839–40.
12). Rahman J., Rashid MA., Yunus AB, et al. Acquired pure red cell aplasia—a case report. Bangladesh Med Res Counc Bull. 1998. 24:79–81.
13). Gregg XT., Prchal JT. Anemia of endocrine disorders. Lichtman MA, Kipps TJ, Kaushansky K, Beutler E, Seligsohn U, Prchal JT, editors. Williams hematology. 7th ed.New York, USA: McGraw-Hill Co.;2006. p. 459–60.
14). Ahn J., Lee K., Lee J, et al. A case of refractory idiopathic pure red cell aplasia responsive to fludarabine treatment. Br J Haematol. 2001. 112:527–9.
crossref
15). Robak T., Kasznicki M., Blonski JZ., Dmoszynska A., Skotnicki AB. Pure red cell aplasia in patients with chronic lymphocytic leukaemia treated with cladribine. Br J Haematol. 2001. 112:1083–5.

Fig. 1
Bone marrow aspirate smear showing marked decrease of erythroid precursors (Wright-Giemsa stain, ×400).
kjh-42-146f1.tif
Fig. 2
Radionuclide (99mTc) scan of the thyroid showing diffuse thyroid enlargement with irregular contour.
kjh-42-146f2.tif
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