Dyserythropoiesis and erythroblast-phagocytosis preceding pure red cell aplasia.

Abstract

A 50-year-old woman with typical acquired primary pure red cell aplasia (PRCA) was successfully treated with prednisone. A later relapse was preceded by a period of ineffective erythropoiesis characterized by a reticulocyte response inappropriately low for the degree of anemia, serum iron of 189 micrograms/dl, total iron-binding capacity (TIBC) of 213 micrograms/dl, and erythroid hyperplasia. In addition there was marked dyserythropoiesis and erythroblast-phagocytosis. One month later, bone marrow examination showed classic PRCA. This rarely reported evolutionary stage of PRCA has several implications: 1) it suggests antibody induced erythroblast cytotoxicity as one mechanism of PRCA; 2) at a particular time in the development of PRCA there is potential for misdiagnosis as primary refractory anemia (PRA); and 3) some cases of PRA with similar morphologic and laboratory findings may be pathogenetically related to PRCA and may benefit from evaluation for immune-mediated suppression of erythropoiesis.

• Authors: M J Keefer, D L Solanki
• Journal: American journal of hematology (Am J Hematol) Vol. 27 Issue 2 Pg. 132-5 (Feb 1988) ISSN: 0361-8609 [Print] United States
• PMID: 3124607 (Publication Type: Case Reports, Journal Article)

Topics

• Bone Marrow (immunology, pathology)
• Erythroblasts (immunology, pathology)
• Erythropoiesis
• Female
• Humans
• Middle Aged
• Phagocytosis
• Red-Cell Aplasia, Pure (blood, immunology, pathology)