2012 Volume 15 Issue 1 Pages 62-66
An 8-year-old girl was admitted to our hospital with fever and purpura. Laboratory examinations showed that the white cell count was 1,300/μl (segmented neutrophil 4.0%, band neutrophil 3.5%, lymphocyte 90.0%, monocyte 1.0%, eosinophil 1.5%), platelet count 2,000/μl, red cell count 363×104/μl, reticulocyte count 1.09×104/μl, and the hemoglobin (Hb) level 10.1 g/dl. Hepatitis and Fanconi anemia were not suspected on the basis of her current medical history, physical examinations and laboratory data, and she was diagnosed with very severe idiopathic aplastic anemia. As she had no brother or sister, she received immunosuppressive therapy with rabbit antithymocyte globulin (ATG) and cyclosporine. The side effects on her skin and bulbar conjunctiva were treated with methylprednisolone. Neutrophil and platelet counts and Hb levels increased to partial remission 3 months later and to complete remission 6 months later. It took more than 5 months to reach a lymphocyte count 500/μl. Since horse ATG is not available at present and there are few reports of using rabbit ATG as a first line therapy, this case presents valuable data that may help overcome some of the remaining problems in the therapeutic use of rabbit ATG.
