Thrombocytopenia and Anemia with Anti-c-Mpl antibodies Effectively Treated with Cyclosporine in a Patient with Rheumatoid Arthritis and Chronic Renal Failure
Thrombocytopenia and Anemia with Anti-c-Mpl antibodies Effectively Treated with Cyclosporine in a Patient with Rheumatoid Arthritis and Chronic Renal Failure
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DOI：
10.2169/internalmedicine.55.5190
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发表时间：
2016-01-01
影响因子：
1.2
通讯作者：
Kato, Junji
中科院分区：
文献类型：
--
作者：
Hashimoto, Akari;Kanisawa, Yuji;Kato, Junji
一位61岁的类风湿关节炎妇女，因终末期肾衰竭而接受血液透析，因严重的血小板减少症和贫血而转至我院。骨髓活检显示巨核细胞和红母细胞完全缺失。环孢素治疗改善了她的巨核细胞和红母细胞水平，降低了她的血清抗c- mpl（血小板生成素受体）抗体水平。在最初的改善后，她的贫血逐渐恶化，尽管持续给予环孢素免疫抑制治疗。她的血小板和白细胞计数保持稳定。这是第一个可能的病例报告抗c- mpl抗体相关的纯红细胞发育不全和获得性无核细胞血小板减少性紫癜。
A 61-year-old woman with rheumatoid arthritis who was undergoing hemodialysis for end-stage renal failure was transferred to our hospital due to severe thrombocytopenia and anemia. A bone marrow biopsy showed the complete absence of megakaryocytes and erythroblasts. Cyclosporine treatment resulted in the improvement of her megakaryocyte and erythroblast levels, and a decrease in her serum level of anti-c-Mpl (thrombopoietin receptor) antibodies. After this initial improvement, her anemia progressively worsened, despite the continuous administration of immunosuppressive therapy with cyclosporine. Her platelet and leukocyte counts remained stable. This is the first report of a probable case of anti-c-Mpl antibody-associated pure red cell aplasia and acquired amegakaryocytic thrombocytopenic purpura.