Dyserythropoiesis and erythroblast-phagocytosis preceding pure red cell aplasia

✍ Scribed by Michael J. Keefer; Dr. Dilip L. Solanki

• Book ID: 101436753
• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 353 KB
• Volume: 27
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830270212

✦ Synopsis

A 50-year-old woman with typical acquired primary pure red cell aplasla (PRCA) was successfully treated with prednisone. A later relapse was preceded by a period of Ineffective erythropolesls characterized by a retlculocyte response Inappropriately low for the degree of anemia, serum iron of 189 pgldi, total Iron-binding capacity (TiBC) of 213 pg/dl, and erythrold hyperplasla. In addition there was marked dyserythropoiesis and erythroblast-phagocytosls. 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 cytotoxlclty 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 erythropolesls.