A case of systemic lupus erythematosus with pure red cell aplasia possibly caused by persistent infection of human parvovirus B 19

• Published in: Nihon Rinshō Menʾeki Gakkai kaishi Vol. 21; no. 5; p. 220
• Main Authors: Mitsunaka, H, Tokuda, M, Takahara, J, Matoba, K, Miyawaki, S
• Format: Journal Article
• Language: Japanese
• Published: Japan 01-12-1998
• Subjects: Aged; Antiphospholipid Syndrome - etiology; Female; Humans; Immunocompromised Host; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - immunology; Methylprednisolone - administration & dosage; Opportunistic Infections - complications; Parvoviridae Infections - complications; Parvoviridae Infections - diagnosis; Parvovirus B19, Human; Prednisolone - adverse effects; Pulse Therapy, Drug; Red-Cell Aplasia, Pure - drug therapy; Red-Cell Aplasia, Pure - etiology; Treatment Outcome
• ISSN: 0911-4300

We reported a 68-old female who was diagnosed to have systemic lupus erythematosus 18 years ago. She had been well under 5 mg of prednisolone until 1995, when she felt severe shortness of breath. Laboratory examinations disclosed severe anemia accompanying mild thrombocytopenia. Bone marrow aspiration revealed a complete absence of erythroid progenitor cells. She was diagnosed to have pure red cell aplasia (PRCA) as well as antiphospholipid syndrome. A judicious use of methylprednisolone including pulse therapy resulted in a prompt resolution of anemia as well as thrombocytopenia and the dose of corticosteroid was tapered successfully thereafter. Persistent infection of HPV B 19 in the patient with inactive SLE was considered as a main cause of PRCA because not only IgG-HPV B 19 antibody but viral DNA was demonstrated in her serum at the time of admission. The relationship between PRCA and anti-phospholipid syndrome in this patient was also noted.