Acquired Pure Red Cell Aplasia in a Patient of Rheumatoid Arthritis

Parida, Prasant; Shukla, Shilin N.; Talati, Shailesh S.; Parikh, Sonia

doi:10.1007/s12288-014-0349-5

Cited by 3 publications

(14 citation statements)

References 7 publications

(6 reference statements)

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“…Other secondary causes of acquired PRCA include lymphoproliferative disorders, pregnancy, hematologic malignancies, nonhematologic neoplasms, of which the association with thymoma is the best known [5]. There are numerous cases of PRCA that have been reported as a secondary manifestation of RA [10][11][12][13][14][15][16][17][18]. Among them, four cases had eosinophilic fasciitis along with PRCA [12].…”

Section: Discussionmentioning

confidence: 99%

“…Pathogenesis of PRCA is heterogenous where it involves immune dysfunction with antibodies directed against erythroid precursor cells or erythropoietin or due to T cell-mediated suppression of erythropoiesis [10,19]. The immunoglobulin (IgG) mediated inhibition of haemoglobin synthesis or complement-binding and direct cytotoxic effect on erythroblasts were found in patients with PRCA, wherein in some patients, the inhibitory antibodies were directed against erythropoietin [20].…”

Section: Discussionmentioning

confidence: 99%

“…There may also be a mild relative lymphocytosis [5]. The bone marrow examination will reveal a complete absence of erythroblasts with normal granulopoiesis and megakaryopoiesis [10,18,19]. As with all diagnostic examinations of the bone marrow for cytopenias, the materials should be collected for cellular immunology, cytogenetics, and clonal analysis of T-cell receptors.…”

Section: Discussionmentioning

confidence: 99%

“…Otherwise, treating PRCA varies with the aetiological factors; however, for primary acquired autoimmune PRCA or secondary PRCA refractory to other therapy, the treatment of choice is immunosuppression [5,17]. The therapeutic plan usually focuses on the sequential use of various immunosuppressive therapies, including corticosteroids, cyclophosphamide, cyclosporin A and anti-thymocyte globulin, splenectomy and plasmapheresis until remission is obtained [10].…”

Section: Discussionmentioning

confidence: 99%

“…Cyclosporin A has become established as one of the leading drugs for the treatment of PRCA. Recently, the e cacies of the anti-CD20 monoclonal antibody, rituximab and anti-CD52 monoclonal antibody, alemtuzumab, to induce remissions of therapy-resistant PRCA have also been reported [10].…”

Section: Discussionmentioning

confidence: 99%

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Pure Red Cell Aplasia Secondary to Rheumatoid Arthritis

Weerasinghe¹,

Karunathilake²,

Ralapanawa³

et al. 2021

Preprint

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BackgroundRheumatoid arthritis (RA) is a common autoimmune disease with many extra-articular manifestations. Pure red cell aplasia (PRCA) is a rare manifestation of RA and is sparsely documented in the literature with a variable clinical outcome following immunosuppressive therapy. Case presentationA 63-year-old female presented with transfusion-dependent anaemia associated with deforming inflammatory arthritis, who also had leukopenia, right subclavian venous thrombosis, and generalized lymphadenopathy. The diagnosis of RA following initial clinical workup and additional blood and bone marrow investigations revealed PRCA as a secondary manifestation of RA after excluding other secondary causes, such as infections, thymoma, thrombophilic conditions and haematological malignancy. She responded well to oral prednisolone, cyclosporine A and hydroxychloroquine, where she attained complete recovery in two months. ConclusionPRCA is a disabling illness that may lead to transfusion-dependent anaemia, which may occur due to rare extrapulmonary manifestation of RA. The diagnosis of PRCA secondary to RA may be challenging where haematological investigations, including bone marrow biopsy, will aid in the diagnosis, and early diagnosis and treatment will bring about a better outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Pure Red Cell Aplasia Secondary to Rheumatoid Arthritis

Weerasinghe¹,

Karunathilake²,

Ralapanawa³

et al. 2021

Preprint

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show abstract

Pure Red Cell Aplasia

Means¹

2018

Anemia in the Young and Old

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Pure red cell aplasia secondary to rheumatoid arthritis: a case report

Weerasinghe¹,

Karunathilake

Ralapanawa

et al. 2021

J Med Case Reports

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Background Rheumatoid arthritis is a common autoimmune disease with many extra-articular manifestations. Pure red cell aplasia is a rare manifestation of rheumatoid arthritis and is sparsely documented in the literature, with a variable clinical outcome following immunosuppressive therapy. Case presentation A 63-year-old Sinhalese female presented with transfusion-dependent anemia associated with deforming inflammatory arthritis. She also had leukopenia, right subclavian venous thrombosis, and generalized lymphadenopathy. The diagnosis of rheumatoid arthritis following initial clinical workup and additional blood and bone marrow investigations revealed pure red cell aplasia as a secondary manifestation of rheumatoid arthritis after excluding other secondary causes, such as infections, thymoma, thrombophilic conditions, and hematological malignancy. She responded well to oral prednisolone, cyclosporine A, and hydroxychloroquine, and she attained complete recovery in 2 months. Conclusion Pure red cell aplasia is a disabling illness that may lead to transfusion-dependent anemia, which may occur due to rare extrapulmonary manifestation of rheumatoid arthritis. The diagnosis of pure red cell aplasia secondary to rheumatoid arthritis may be challenging where hematological investigations, including bone marrow biopsy, will aid in the diagnosis, and early diagnosis and treatment will bring about a better outcome.

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Acquired Pure Red Cell Aplasia in a Patient of Rheumatoid Arthritis

Abstract: Pure red cell aplasia (PRCA) is characterized as a normocytic anemia associated with reticulocytopenia and

Cited by 3 publications

References 7 publications

Pure Red Cell Aplasia Secondary to Rheumatoid Arthritis

Pure Red Cell Aplasia Secondary to Rheumatoid Arthritis

Pure Red Cell Aplasia

Pure red cell aplasia secondary to rheumatoid arthritis: a case report

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