Uchiyama M, Ichikawa Y, Komatsuda M, Miyairi A, Arimori S
Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.
Intern Med. 1992 Nov;31(11):1277-80. doi: 10.2169/internalmedicine.31.1277.
A 65-year-old male patient developed acquired chronic pure red cell aplasia (PRCA) associated with hypergammaglobulinemia and positive Coombs' test during the treatment of eosinophilic pneumonia with prednisolone (PSL). His PRCA was treated with oral PSL at a dose of 60 mg/day for 3 weeks, but anemia further progressed. Immediately after high-dose intravenous pulse methylprednisolone therapy (1 g/day for 3 days) however, reticulocyte crisis occurred and his anemia rapidly improved. He has been in complete remission under a maintenance dose of PSL for more than 2 years. This patient indicates that high-dose intravenous methylprednisolone therapy is one of the useful treatments, not only for constitutional PRCA, but also for acquired chronic PRCA.
一名65岁男性患者在使用泼尼松龙(PSL)治疗嗜酸性粒细胞性肺炎期间发生了获得性慢性纯红细胞再生障碍性贫血(PRCA),伴有高球蛋白血症和库姆斯试验阳性。他的PRCA接受了口服PSL治疗,剂量为60mg/天,持续3周,但贫血进一步加重。然而,在大剂量静脉脉冲甲基泼尼松龙治疗(1g/天,共3天)后立即出现网织红细胞危象,贫血迅速改善。他在PSL维持剂量下完全缓解已超过2年。该患者表明,大剂量静脉甲基泼尼松龙治疗不仅是先天性PRCA的有效治疗方法之一,也是获得性慢性PRCA的有效治疗方法之一。