Pure Red Cell Aplasia Caused by Azathioprine

Author(s): Dimitris Kounatidis, Natalia Vallianou*, Vasiliki Daskalaki, Christos Masaoutis, Evangelia Margellou, Nikos Harhalakis, Evangelos Kokkinakis

Journal Name: Cardiovascular & Hematological Disorders-Drug Targets
Formerly Current Drug Targets - Cardiovascular & Hematological Disorders

Volume 20 , Issue 2 , 2020

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Graphical Abstract:


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 treatment.

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.

Keywords: Azathioprine, pure red cell aplasia, adverse effect, malignancies, anemia, collagen vascular diseases.

Dessypris, E.N.; Lipton, J.M. Red cell aplasia In: Wintrobe’s clinical hematology; 11th ed; Greer, J.; Foerster, J.; Lukens, J.N.; Rodgers, G.M.; Paraskevas, F.; Glader, B., Eds.; Lippincott Williams & Wilkins: Philadelphia. , 2004; pp. 1421-1427.
Means, R.T., Jr Pure red cell aplasia. Blood, 2016, 128(21), 2504-2509.
[http://dx.doi.org/10.1182/blood-2016-05-717140] [PMID: 27881371]
Koduri, P.R.; Vanajakshi, S.; Anuradha, R. Azathioprine-associated pure red cell aplasia in renal transplant recipients: a report of two cases. Ann. Hematol., 2014, 93(2), 329-330.
[http://dx.doi.org/10.1007/s00277-013-1779-0] [PMID: 23680868]
Connell, W.R.; Kamm, M.A.; Ritchie, J.K.; Lennard-Jones, J.E. Bone marrow toxicity caused by azathioprine in inflammatory bowel disease: 27 years of experience. Gut, 1993, 34(8), 1081-1085.
[http://dx.doi.org/10.1136/gut.34.8.1081] [PMID: 8174958]
Young, N.S. Pure red cell aplasia In: Williams Hematology; 8th ed; Lichtman, M.A.; Ernest, K.; Thomas, J.S., Eds.; McGraw-Hill Health Professions Division: New York. , 2010; pp. 485-494.

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Article Details

Year: 2020
Page: [164 - 165]
Pages: 2
DOI: 10.2174/1871529X18666180828145818
Price: $65

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