Journal List > J Korean Rheum Assoc > v.14(4) > 1003589

Lee, Kim, Lee, Seol, Baek, Cho, Lee, Kim, and Lee: A Case of Aplastic Anemia Associated with Systemic Lupus Erythematosus: Successful Treatement with Cyclosporine

Abstract

Systemic lupus erythematosus(SLE) is autoimmune disease in which involves systemic organs. Hematological manifestations are common in patients with SLE but aplastic anemia is very rare and, although various immunosuppressants have been tried, there is no established treatment in aplastic anemia associated with SLE. Furthermore, disease course and prognosis may be different from other aplastic anemia. A 42-year-old woman presented with fever, chilling, myalgia, general weakness, pancytopenia. Her bone marrow aspirate and biopsy revealed almost acellular bone marrow with rare foci of hematopoietic elements and she was diagnosed with SLE simultaneously. High-dose methyprednisolone, prednisolone and cyclophosphamide therapies had been unsuccessful in controlling pancytopenia. Cyclosproine was started and the aplastic anemia was responded. Now she was free of transfusion with more than 10 g/dL of hemoglobin.

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Fig. 1.
The bone marrow biopsy (H&E stain, x 100). The specimen shows marked hypocelluar marrow (cellualarity < 10%).
jkra-14-384f1.tif
Fig. 2.
Serum hemoglobin and creatinine level during follow up.
jkra-14-384f2.tif
Table 1.
The laboratory findings of patients during follow up
Day 1 Day 6 Day 10 Day 14 Day 27 Day 30 Day 40 Day 54 Day 71 Day 110 Day 254
Hb (g/dL) 8.6 10.4 7.2 9.7 9.2 7.7 9.2 10.1 10.5 12.7
WBC (/mm3) 500 4,300 9,490 4,050 9,240 3,760 4,280 2,810 5,510 5,400
Plt (/mm3) 51,000 128,000 55,000 114,000 181,000 97,000 218,000 255,000 337,000 323,000
Cr. (mg/dL) 1.5 2.9 2.9 1.3 1.1 1.1 0.9 1.1 0.9 1.1
C3 (90-180 mg/dL) 25.1 41.2 41.9 54.9 91.7 107.1
C4 (10-40 mg/dL) 8.7 8.6 8.8 16.3 16.5 20.5
CH50 (23.0 - 46.0 U/mL) 4.8 17.2 6.5 33.0 50.5 55.4
Anti-dsDNA Ab (0-25 IU/mL) 310 132 21 9 3 7
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