PURE RED-CELL APLASIA - REPORT OF 3 CASES WITH STUDIES ON CIRCULATING TOXIC FACTORS AGAINST ERYTHROID PRECURSORS

Summary: Three cases of pure red cell aplasia (PRCA) are reported. PRCA developed with no apparent cause in the first case, was associated with histiocytic lymphoma in the second and with diphenylhydantoin therapy in the third. In vitro studies showed the presence of toxic factors against erythroid precursors in the second and third cases. It is argued that the absence of such factors in the serum of the first case does not rule out antibody‐mediated damage to erythroid precursors in vivo as the demonstration in vitro would require antibody excess in vivo. Steroids induced a remission in the first two cases providing further evidence that an immunological mechanism is responsible for the PRCA. Withdrawal from diphenylhydantoin plus steroid therapy induced a rapid remission in the third case. Copyright © 1978, Wiley Blackwell. All rights reserved