EMMANUEL N. DESSYPRIS, M.D.; MARIA R. BAER, M.D.; JOHN S. SERGENT, M.D.; SANFORD B. KRANTZ, M.D.
Three patients with severe, deforming, and long-standing rheumatoid arthritis developed pure red cell aplasia that did not remit after withdrawal of medications, ran a chronic course, and in two patients remitted only after cytotoxic immunosuppressive treatment. An IgG inhibitor of autologous erythroid colony-forming and burst-forming unit growth in vitro was found in the serum of one patient. This specific erythropoietic inhibitor persisted in lower titer in the patient's serum even after an azathioprine-induced remission of pure red cell aplasia, indicating the possible need for maintenance immunosuppressive therapy. Chronic pure red cell aplasia may be another extra-articular manifestation of rheumatoid arthritis and should be considered when severe anemia develops in the absence of blood loss or hemolysis.
DESSYPRIS EN, BAER MR, SERGENT JS, et al. Rheumatoid Arthritis and Pure Red Cell Aplasia. Ann Intern Med. 1984;100:202–206. doi: 10.7326/0003-4819-100-2-202
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Published: Ann Intern Med. 1984;100(2):202-206.
Hematology/Oncology, Red Cell Disorders, Rheumatoid Arthritis, Rheumatology.
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