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Pure red cell aplasia (PRCA) is characterized by normocytic normochromic anemia, severe reticulocytopenia, and a total absence or marked reduction of erythroid precursors in the bone marrow. It can...

Pure red cell aplasia (PRCA) is a rare autoimmune phenomenon in chronic lymphocytic leukemia (CLL) (1% incidence in some series).[1,2] When it occurs, it is difficult to control, more difficult tha...

Human parvovirus B19 (PV B19) infection in children commonly presents as fifth disease. Transient red cell crisis, the other manifestation of PV B19 infection, is usually reported in children with chronic hemolytic anemia, with a worsening of the anemia. However, this condition may pass unrecognized in children without an underlying hemolytic disorder, since the anemia may be of a short duration and self-limiting. The authors report 3 cases of PV B19-induced transient aplastic in different clinical settings--pancytopenia in one child, during induction phase for acute lymphoblastic leukemia in the second, and fever with joint pains in the third. Treatment for PV B19-induced transient aplastic crisis is essentially supportive. There may be a dilemma in patients on immunosuppressive therapy, since initially it is difficult to distinguish between chronic pure red cell aplasia (a condition where intravenous immunoglobulin therapy is beneficial) and transient aplastic crisis, where supportive red cell transfusions suffice. The patient with leukemia also recovered spontaneously despite being on steroids. In all the 3 patients, the pure red cell aplasia recovered spontaneously without administration of intravenous gammaglobulins.

An elderly man presented with a macrocytic anemia with severe reticulocytopenia. The observation of trilineage dysplasia in addition to red cell aplasia led to a diagnosis.

The refusal of Jehovah's Witnesses to accept blood and blood products often poses a clinical dilemma to present day medicine. We present a case of a Jehovah's Witness who had undergone renal transplantation, only to develop an Epstein-Barr virus associated aggressive lymphoma post-transplant. His condition was further complicated by erythrovirus (parvovirus) B 19 infection resulting in red cell aplasia and severe anemia. The management of this difficult clinical situation is discussed together with a review of recommendations for chemotherapy treatment in Jehovah's Witnesses.

A 47-year-old woman (MC) with severe anemia and red cell aplasia was found to have a serum monoclonal immunoglobulin component (M-component) but no evidence of overt multiple myeloma. The patient w...