A case of pure red cell aplasia (PRCA) with T-cell lymphocytosis was reported.
A 33-year-old man was admitted to our hospital, because of anemia.
Peripheral blood examination showed RBC 262×104/cmm, Hb 8.6g/dl, WBC 10,700/cmm with lymphocyte 86.0%, and platelet 57.4×104/cmm. Bone marrow examination revealed severe erythroid hypoplasia and 60.0% lymphocytes. The lymphocytes had large granules in cytoplasm and surface phenotypes of cytotoxic/suppressor T-cell (Tγ-cell), (E (+), T3 (+), T4 (-), T8 (+), Ia (+), Leu7 (+), IgG Fc receptor (+)).
By functional analysis, these lymphocytes displayed natural killer (NK) activity and antibody-dependent cell-mediated cytotoxicity (ADCC) activity. The diagnosis of PRCA with T-cell lymphocytosis was made.
He was successfully treated with cyclophosphamide and metenolone.
These findings suggest that T-cell-mediated inhibition of erythropoiesis is the pathogenetic mechanism of PRCA in this case.
