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August 1974

Remission in Pure Red Blood Cell Aplasia Following Immunosuppressive Therapy

Author Affiliations

Northport, NY; Boston; La Jolla, Calif

From the Blood Research Laboratory, New England Medical Center hospitals and the Department of Medicine, Tufts University School of Medicine, Boston. Dr. Zucker is now with the Northport (NY) Veterans Administration Hospital. Dr. Crosby is now with the Scripps Clinic and Research Foundation, La Jolla, Calif.

Arch Intern Med. 1974;134(2):317-320. doi:10.1001/archinte.1974.00320200127018

Pure red blood cell aplasia (PRCA) is a rare disease that has attracted an extraordinary amount of interest because of the associated abnormalities of the immunological system. Recently, Krantz, Kao, Safdar, and Brown have reported on four patients with PRCA, in which a circulating IgG antibody directed against marrow erythroblasts was demonstrated.1-4 Immunosuppressive therapy resulted in amelioration of the anemia in three of these patients.1-3 This report describes a fourth case of PRCA in which both an IgG antibody to human erythroblasts was demonstrated and in which a hematological remission was obtained with immunosuppressive therapy.

Patient Summary  A white woman (Fig 1) was relatively well until May 1963 when, at age 55 years, she developed a profound anemia. No contact with toxic agents or recent medication was noted. Splenomegaly was found on physical examination.Laboratory examination revealed the following values: hemoglobin, 4.2 gm/100 ml; hematocrit, 12%; red blood

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