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

• Published in: Japanese Journal of Clinical Immunology Vol. 21; no. 5; pp. 220 - 225
• Main Authors: Mitsunaka, Hiroki, Tokuda, Michiaki, Takahara, Jiro, Matoba, Kenichiro, Miyawaki, Shoji
• Format: Journal Article
• Language: English
• Published: The Japan Society for Clinical Immunology 31.12.1998
• Subjects: anti-phospholipid syndrome; human parvovirus B 19; pure red cell aplasia; systemic lupus erythematosus
• ISSN: 0911-4300; 1349-7413
• DOI: 10.2177/jsci.21.220

We reported a 68-old female who was diagnosed to have systemic lupus erythematosus 18 years ago. She had been well under 5mg 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.