Treatment of pure red-cell aplasia with cyclosporine in a renal transplant patient

Exp Clin Transplant. 2013 Feb;11(1):63-5. doi: 10.6002/ect.2012.0066. Epub 2012 Aug 11.

Abstract

Acquired pure red-cell aplasia is a rare disorder that can be either idiopathic or associated with certain autoimmune diseases, pregnancy, lymphoproliferative disorders, nutritional deficiencies, or medicines. We present a deceased-donor renal transplant patient who developed pure red-cell aplasia associated with mycophenolate mofetil or tacrolimus and was treated with cyclosporine. A 20-year-old woman was transplanted from a deceased donor 1 month earlier and presented to us with symptoms of fatigue, prostration, and palpitation. The results of a laboratory examination revealed anemia. A diagnostic work-up resulted in a diagnosis of pure red-cell aplasia. Mycophenolate mofetil was discontinued. Tacrolimus also was replaced with cyclosporine 2 months after mycophenolate mofetil was halted because of a lack of improvement in anemia. Three months later, her anemia improved with cyclosporine. Starting cyclosporine instead of tacrolimus or mycophenolate mofetil showed good improvement in our patient within 6 months of therapy.

Publication types

  • Case Reports

MeSH terms

  • Cyclosporine / therapeutic use*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney / physiology
  • Kidney Diseases / immunology
  • Kidney Diseases / surgery
  • Kidney Transplantation / immunology
  • Mycophenolic Acid / adverse effects
  • Mycophenolic Acid / analogs & derivatives*
  • Mycophenolic Acid / therapeutic use
  • Red-Cell Aplasia, Pure / chemically induced*
  • Red-Cell Aplasia, Pure / drug therapy*
  • Tacrolimus / adverse effects*
  • Tacrolimus / therapeutic use
  • Treatment Outcome
  • Withholding Treatment
  • Young Adult

Substances

  • Immunosuppressive Agents
  • Cyclosporine
  • Mycophenolic Acid
  • Tacrolimus