“…It may be an early manifestation of an intrinsic stem cell abnormality, as some patients subsequently develop aplastic anemia, myelodysplastic syndrome (MDS) and acute leukemia [1,4]. However, it has also been reported with systemic lupus erythematosus (SLE) [5][6][7] and vitamin B 12 deficiency [8], suggesting an underlying immune aberration in some cases. Although there were occasional spontaneous remissions, most sustained ones were in patients receiving immunosuppressive therapy, such as corticosteroids [1,7,9], cyclosporin A [4,12], antithymocyte globulin (ATG) [9][10][11], danazol [13], immunoglobulin (IVIG) [14], or cyclophosphamide [15].…”