Cytomegalovirus-induced Pure Red Cell Aplasia Successfully Treated with Ganciclovir: A Case Report
Journal Title: International Blood Research & Reviews - Year 2015, Vol 3, Issue 4
Abstract
Background: Acquired pure red cell aplasia (PRCA) is a rare disease characterized by anemia, severe reticulocytopenia and absent to low bone marrow erythroid precursor cells. There are well-described associations of this disorder with thymomas, lymphoproliferative disorders, autoimmune disorders, certain drugs, and infectious agents. Among the infectious agents, the most common is parvovirus B19, this was rarely reported in association with Cytomegalovirus (CMV). Objective: To describe a rare case of acquired PRCA associated with CMV and its response to antiviral therapy. Methods: We present the clinical and laboratory data of our patient and reviewed the related published literature regarding PRCA, its etiology and response to treatment. Results: We describe a 64-year-old male who presented with symptomatic anemia. He had a normocytic, normochromic anemia associated with low reticulocyte count. Serum ferritin was elevated. Vitamin B12, folate levels, kidney and liver functions were normal. He was given blood transfusion with packed red cells, hematinics and erythropoietin (EPO) injections for 2 months but there was no response. Bone marrow aspiration and biopsy showed erythroid hypoplasia consistent with PRCA. He was assessed to have PRCA probably EPO-antibody induced. EPO was discontinued and he was started on steroids. After 3 months of steroids there was persistence of anemia and reticulocytopenia. EPO-antibody assay done prior to steroid therapy came out to be negative. He tested negative for Hepatitis A, B and C, Human Immunodeficiency virus, Epstein barr-virus and parvovirus B-19.CMV DNA viral load was elevated. He was started on ganciclovir which resulted to transfusion independence and normalization of hemoglobin. Conclusion: PRCA may be reversible. High viral load of CMV was detected through PCR. He was treated with antiviral therapy resulting into a favorable response.
Authors and Affiliations
Flordeluna Zapata-Mesina, Daisy Ilagan-Tagarda, John S. Delgado, Jomell C. Julian
Keywords
Related Articles
- EP ID EP242486
- DOI 10.9734/IBRR/2015/17728
- Views 119
- Downloads 0
Impaired Appropriateness of Erythropoietin in Anaemic HIV Infected Patients
Background and Objective: Erythropoietin response to anaemia has been reported to be suboptimal in HIV infected anaemic patients. Among Africans, particularly Nigeria little or no reports have been published describing i...
A Case Report of Pregnant Woman with Aplastic Anemia: Diagnosis and Management through Subsequent Pregnancy
Introduction: Aplastic anemia is characterized by decreased bone marrow function with inadequate production of erythrocytes, granulocytes, and platelets. Marrow failure may be caused by absence of or defects in hematopoi...
Knowledge and Beliefs of Blood Cancer among Affected and Unaffected Persons in Benin City, Nigeria
Introduction: Awareness and adequate knowledge regarding blood cancers is a crucial intervention for proper management and control. Objectives: This study aimed to quantify and compare the level of knowledge among affec...
In vitro Anti-erythrocyte Sickling Effect of Lunularic Acid of Natural Origin
Aims: To evaluate the antisickling activity of lunularic acid. Study Design: Biological experiment in vitro (Emmet test), evaluation of cell morphological parameters such as radius, perimeter and surface. Place and Durat...
Thrombin Structural and Functional Determinants as Therapeutic Targets
Thrombin is the final serine protease generated during blood coagulation. This enzyme possesses a complex and fascinating structure composed not only by an active site but also by two positively charged patches, called a...