Background: Pure red cell aplasia (PRCA) is a clinical entity comprising severe normochromic
normocytic anemia, reticulocytopenia, erythroblastopenia in the bone marrow, with normal
leukocyte and platelets count. PRCA can be classified into congenital and acquired, with the latter
characterized as idiopathic or secondary to various infections, hematological malignancies, collagen
vascular diseases, thymoma, and exposure to a variety of drugs and other chemical substances.
Methods: Herein, we present a female patient, who presented with PRCA due to azathioprine
Results: Prompt discontinuation of the drug together with red blood cells transfusions led to complete
recovery in this young patient, without any addition of immunosuppressive regimen.
Conclusion: We followed ‘the wait and see practice’ instead of administering immunosuppression
to our patient, after careful consideration and extensive consultation with our hematologists. This
‘wait and see practice’ proved to be effective in the long run.