CASE REPORT

A case of pure red cell aplasia complicated by Evans syndrome

Authors

Yasuhiko Toyokawa^1,2, Isamu Kingetsu¹, Chiho Yasuda¹, Jun Yasuda¹, Ken Yoshida¹, Daitaro Kurosaka¹ and Akio Yamada¹

1. Division of Rheumatology, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan
2. Present address: Toyokawa Clinic, 3-22-12 Kotesashi-cho, Tokorozawa 359-1141, Japan

Received:

06 December 2006

Accepted:

05 March 2007

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Abstract

A 33-year-old woman complaining of severe anemia was admitted to our hospital for polyclonal hyperglobulinemia. She was diagnosed with pure red cell aplasia (PRCA) associated with Evans syndrome. Initially, the presence of human parvovirus B19 (HPV B19) IgM appeared to indicate that the cause of PRCA was HPV B19 infection. Evans syndrome improved with steroid therapy, but PRCA was refractory. Cyclosporine was administered; consequently, the patient markedly recovered from PRCA and was discharged. PRCA complicated by Evans syndrome occurred during the course of polyclonal hyperglobulinemia. The most direct etiology for the onset of PRCA was unclear; however, immunological disorders such as polyclonal hyperglobulinemia, in addition to HPV B19 infection, may have been partly responsible for the etiology of PRCA.

Key words

Cyclosporine - Evans syndrome - Human parvovirus B19 - Polyclonal hyperglobulinemia - Pure red cell aplasia