Abstract
A 73-year-old male with diabetic nephropathy of 2 years' duration was admitted to our hospital because of severe anemia. Blood examination showed severe anemia with no reticulocytes and bone marrow smear revealed marked erythroid hypoplasia. Blood chemistry showed high serum level of erythropoietin and mild elevation of serum creatinine level. From the above findings, a diagnosis of PRCA complicated with diabetic nephropathy was made.
To investigate the pathogenesis of PRCA in this case, we used in vitro culture technique to study the effect of patient's IgG on erythroid colony formation. The patient's IgG markedly inhibited erythroid colony formation (CFU-E) from normal marrow. This inhibitory effect of patient's IgG was complement independent and subsided when the patient's IgG was pretreated with anti-human IgG rabbit serum. These findings suggest that serum IgG inhibitor to erythropoiesis may contributed to the cause of PRCA in this case.
