Abstract
A 39 year-old man was admitted to our hospital because of acute hepatitis on the 4th of May 1986. The liver function test showed a marked elevation of serum transaminases and total bilirubin (GOT 706 IU/l, GPT 1068 IU/l, T. Bil 33.7 mg/dl). Antigen and antibody to hepatitis B were negative, but antibody to hepatitis A was positive and IgM index was 8.1. The liver function test improved gradually, but anemia and reticulocytopenia with thrombocytopenia (Hb. 7.9 g/dl, Retic. 0‰, Plt. 5.2×104/mm3) was noted on the 17th hospital day. Bone marrow showed marked depretion of erythroid series (Erythroid series 0.4%, M/E ratio 211.5). A diagnosis of pure red cell aplasia (PRCA) was done, but reticulocyte recovered spontaneously follwed by a temporary elevation of leukocyte and thrombocyte (Hb. 4.7 g/dl, Retic. 16‰, WBC 56,500/mm3, Plt. 201.9×104/mm3) on the 23th hospital day. Bone marrow showed erythroid hypreplasia (Erythroid series 40.2%, M/E ratio 1.3). Prednisolone (30 mg/day) was administered because of shortening of red cell life span, and then anemia improved with decrease of reticulocyte. The serum and IgG taken during acute phase of PRCA did not inhibit both CFU-E and CFU-GM of autologous bone marrow after remission. This case is the first report that developed acute PRCA after hepatitis A.
