ABSTRACT
Pure red cell aplasia(PRCA) is characterized by anemia, absence of reticulocytes in the peripherial blood and selective erythroid hypoplasia in the bone marrow. Acquired PRCA is often associated with thymoma but may also occur in many diverse conditions, such as chromic lymphocytic leukemia, systemic lupus erythematosus, autoimmune disorders, T gamma lymphocytosis, acquired hypogammaglobulinemia, acquired immunodeficiency syndrome. Recently we experienced a case of T cell chronic lymphocytic leukemia associated with pure red cell aplasia. A 65-year-old man was presented with severe anemia. absolute reticulocytopenia, hepatosplenomegaly and lymphocytosis(T cell marker' CD2, CD7 positive). Bone marrow findings showed a marked decrease in erythroid precursors and normal maturations of granulocytic and megakaryocytic series, which were consistent with pure red cell aplasia. So we report this case with a review of the literature.
Subject(s)
Aged , Humans , Acquired Immunodeficiency Syndrome , Anemia , Bone Marrow , Common Variable Immunodeficiency , Leukemia, Lymphocytic, Chronic, B-Cell , Leukemia, Lymphoid , Lupus Erythematosus, Systemic , Lymphocytosis , Red-Cell Aplasia, Pure , Reticulocytes , ThymomaABSTRACT
Primary idiopathic polymyositis is a condition of presumed autoimmune etiology in which the skeletal muscle is damaged by a nonsuppurative inflammatory process dominated by lymphocytic infiltration. We recently experienced a patient with primary idiopathic Polymyositis associated with hypoalbuminemia and thrombocytopenia. About 4 months prior to admission, he was diagnosed as primary idiopathic polymyositis, and improved by treatment with prednisolone 60 mg/day. During steroid tapering, muscle weakness was recurred and accompanied by hypoalbuminemia and thrombocytopenia. Despite retreatment with prednisolone 60 mg/day, muscle weakness, hypoalbuminemia and thrombocytopenia persisted. He was then started to administer methotrexate(MTX) 15 mg/week which resulted in prompt improvement of muscle weakness, hypoalbuminemia and thrombocytopenia. These findnigs suggest that primary idiopathic polymyositis is one of the cause of hypoalbuminemia and thrombocytopenia, and that the hypoalbuminemia and thrombocytopenia can be improved promptly by methotrexate treatment.