Pure red cell aplasia and protein-losing enteropathy in a patient with systemic lupus erythematosus

✍ Scribed by Louis W. Heck; Graciela S. Alarcón; Gene V. Ball; Robert L. Phillips; Lanning B. Kline; Hernan Moreno; Basil I. Hirschowitz; Alan N. Baer; Emmanuel N. Dessypris

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 327 KB
• Volume: 28
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780280914

✦ Synopsis

We report the case of a young woman with systemic lupus erythematosus (SLE) complicated by protein-losing enteropathy, pure red cell aplasia (PRCA), transient anisocoria, laboratory evidence of autoimmune thyroiditis, and immune thrombocytopenia. Protein-losing enteropathy and PRCA are unusual manifestations of SLE (1,2) which, to our knowledge, have not been previously reported to occur in the same patient.

Case report. This 22-year-old white woman presented at age 17 with extreme fatigue, palpitations, and pallor, 2 weeks after a mild febrile illness characterized by upper and lower respiratory tract symptoms. She had taken acetaminophen and propoxyphene hydrochloride for dysmenorrhea 3 weeks previously and pseudoephedrine hydrochloride and chlorpheniramine maleate during the antecedent respiratory illness.

Laboratory studies revealed a hematocrit value of 14.6%, red blood cell count of 1.59 X 106/pl, hemoglobin of 4.7 gm/IOO ml, reticulocyte count of 0.3%, and haptoglobin level of 110 mg/dl. The direct Coombs' test showed a positive result. The white ~~