Yoshida-Hiroi Mayumi, Koizumi Masayuki, Oka Reiko, Mitsuda Aki, Hiroi Naoki
Department of Internal Medicine, Kawasaki Social Insurance Hospital, Japan.
Intern Med. 2011;50(9):1051-4. doi: 10.2169/internalmedicine.50.4303. Epub 2011 May 1.
A 70-year-old Japanese man with chronic kidney disease under treatment with oral prednisolone for organizing pneumonia developed pulmonary aspergilloma. The patient was started on micafungin (MCFG), with no addition of any other new drug. About 5 weeks later, aggravation of his normocytic anemia associated with a low reticulocyte count was observed. Bone marrow puncture and biopsy revealed intense hypoplasia of the erythroblasts. As there was no evidence of malignancy, human parvovirus B19 infection, autoimmune diseases or hemorrhage, the patient was diagnosed as having acquired pure red cell aplasia (PRCA). The anemia improved along with an increase of the reticulocyte count to the normal level within 12 weeks of discontinuation of the MCFG therapy. The patient showed no evidence subsequently of any recurrence of the normocytic normochromic anemia or relapse of the PRCA. This is the first reported case of PRCA associated with MCFG.
一名70岁的日本男性，患有慢性肾脏病，因机化性肺炎接受口服泼尼松龙治疗，随后发生了肺曲菌球。该患者开始使用米卡芬净（MCFG）治疗，未添加任何其他新药。约5周后，观察到他出现了正细胞性贫血加重，同时网织红细胞计数降低。骨髓穿刺和活检显示成红细胞显著发育不全。由于没有恶性肿瘤、人细小病毒B19感染、自身免疫性疾病或出血的证据，该患者被诊断为获得性纯红细胞再生障碍性贫血（PRCA）。在停用MCFG治疗后的12周内，随着网织红细胞计数增加至正常水平，贫血情况有所改善。该患者随后未出现正细胞正色素性贫血复发或PRCA复发的迹象。这是首例报道的与MCFG相关的PRCA病例。
