Cargando…
Refractory anemia in human immunodeficiency virus: Expect the unexpected
Pure red cell aplasia (PRCA) is an uncommon hematological disorder affecting selectively the erythroid cell lines. PRCA is defined as anemia with normal leukocyte and platelet counts, a corrected reticulocyte count <1%, <5% erythroid precursors in the bone marrow and an absence of hemolysis. W...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290798/ https://www.ncbi.nlm.nih.gov/pubmed/28217621 http://dx.doi.org/10.4103/2249-4863.197288 |
_version_ | 1782504707465412608 |
---|---|
author | Mirgh, Sumeet Prakash Mishra, Vikas A. Shah, Virti D. Sorabjee, Jehangir Soli |
author_facet | Mirgh, Sumeet Prakash Mishra, Vikas A. Shah, Virti D. Sorabjee, Jehangir Soli |
author_sort | Mirgh, Sumeet Prakash |
collection | PubMed |
description | Pure red cell aplasia (PRCA) is an uncommon hematological disorder affecting selectively the erythroid cell lines. PRCA is defined as anemia with normal leukocyte and platelet counts, a corrected reticulocyte count <1%, <5% erythroid precursors in the bone marrow and an absence of hemolysis. We describe a case of Zidovudine (AZT) induced PRCA causing severe anemia in a patient taking antiretroviral therapy (ART) after 4 months of starting therapy and in whom all other causes were excluded. The hematological abnormalities resolved after AZT was replaced with tenofovir and the patient remained transfusion independent thereafter. A slowly progressive normocytic-normochromic anemia and reticulocytopenia, without leukopenia and thrombocytopenia in a patient, should raise the suspicion of PRCA. Search for underlying diseases, infections and drugs may help in the diagnosis and etiology of acquired PRCA. Elimination of potentially causative factors may induce complete recovery. AZT is a well-known cause of anemia and thus should be used with caution in the initiation of ART. |
format | Online Article Text |
id | pubmed-5290798 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-52907982017-02-17 Refractory anemia in human immunodeficiency virus: Expect the unexpected Mirgh, Sumeet Prakash Mishra, Vikas A. Shah, Virti D. Sorabjee, Jehangir Soli J Family Med Prim Care Case Report Pure red cell aplasia (PRCA) is an uncommon hematological disorder affecting selectively the erythroid cell lines. PRCA is defined as anemia with normal leukocyte and platelet counts, a corrected reticulocyte count <1%, <5% erythroid precursors in the bone marrow and an absence of hemolysis. We describe a case of Zidovudine (AZT) induced PRCA causing severe anemia in a patient taking antiretroviral therapy (ART) after 4 months of starting therapy and in whom all other causes were excluded. The hematological abnormalities resolved after AZT was replaced with tenofovir and the patient remained transfusion independent thereafter. A slowly progressive normocytic-normochromic anemia and reticulocytopenia, without leukopenia and thrombocytopenia in a patient, should raise the suspicion of PRCA. Search for underlying diseases, infections and drugs may help in the diagnosis and etiology of acquired PRCA. Elimination of potentially causative factors may induce complete recovery. AZT is a well-known cause of anemia and thus should be used with caution in the initiation of ART. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5290798/ /pubmed/28217621 http://dx.doi.org/10.4103/2249-4863.197288 Text en Copyright: © Journal of Family Medicine and Primary Care http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Case Report Mirgh, Sumeet Prakash Mishra, Vikas A. Shah, Virti D. Sorabjee, Jehangir Soli Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title | Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title_full | Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title_fullStr | Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title_full_unstemmed | Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title_short | Refractory anemia in human immunodeficiency virus: Expect the unexpected |
title_sort | refractory anemia in human immunodeficiency virus: expect the unexpected |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5290798/ https://www.ncbi.nlm.nih.gov/pubmed/28217621 http://dx.doi.org/10.4103/2249-4863.197288 |
work_keys_str_mv | AT mirghsumeetprakash refractoryanemiainhumanimmunodeficiencyvirusexpecttheunexpected AT mishravikasa refractoryanemiainhumanimmunodeficiencyvirusexpecttheunexpected AT shahvirtid refractoryanemiainhumanimmunodeficiencyvirusexpecttheunexpected AT sorabjeejehangirsoli refractoryanemiainhumanimmunodeficiencyvirusexpecttheunexpected |