Abstract
A 42-year-old woman with systemic lupus erythematosus was admitted to our hospital because of severe anemia. Her bone marrow was almost normocellular and erythroblasts were nearly absent. Laboratory data showed elevated levels of lactate dehydrogenase and positive findings on Coombs' tests. On the basis of these findings, her anemia was diagnosed as the overlap of pure red cell aplasia with autoimmune hemolytic anemia. Radioimmunoprecipitation assay revealed that her serum was positive for anti-erythropoietin antibodies before therapy. Furthermore, the autoantibodies inhibited proliferation of an erythropoietin-dependent cell line in a dose-dependent manner. Immunosuppressive treatment improved the anemia accompanied with disappearance of the autoantibodies.
Copyright 2008 Wiley-Liss, Inc.
MeSH terms
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Adult
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Anemia, Hemolytic, Autoimmune / drug therapy
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Anemia, Hemolytic, Autoimmune / etiology*
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Anemia, Hemolytic, Autoimmune / immunology
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Antibody Specificity
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Autoantibodies / blood
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Autoantibodies / immunology*
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Bone Marrow / pathology
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Cell Division / drug effects
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Cell Line / drug effects
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Erythroid Precursor Cells / drug effects
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Erythropoietin / immunology*
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Female
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Humans
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Immunosuppressive Agents / administration & dosage
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Immunosuppressive Agents / therapeutic use
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Lupus Erythematosus, Systemic / blood
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Lupus Erythematosus, Systemic / complications
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Lupus Erythematosus, Systemic / drug therapy
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Lupus Erythematosus, Systemic / immunology*
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Methylprednisolone / administration & dosage
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Methylprednisolone / therapeutic use
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Prednisolone / administration & dosage
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Prednisolone / therapeutic use
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Red-Cell Aplasia, Pure / drug therapy
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Red-Cell Aplasia, Pure / etiology*
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Red-Cell Aplasia, Pure / immunology
Substances
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Autoantibodies
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Immunosuppressive Agents
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Erythropoietin
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Prednisolone
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Methylprednisolone