Sidi Mohamed Ben Abdellah University, Faculty of Medicine and Pharmacy, Fez, Morocco.
Department of Clinical Haematology, Moulay Ismail Military Teaching Hospital, Meknes, Morocco.
J Med Case Rep. 2022 Oct 19;16(1):375. doi: 10.1186/s13256-022-03545-x.
Coronavirus disease 2019, caused by severe acute respiratory coronavirus 2, has been responsible, since December 2019, for a severe pandemic resulting in millions of deaths worldwide, and the number is still increasing. Although coronavirus disease 2019 is mostly a respiratory syndrome, it is considered a multisystemic disease and shows clinical diversity with a wide range of manifestations including hematological features.
We present the case of an Arab male, 77 years old, who developed severe anemia 8 weeks after acute infection with severe acute respiratory coronavirus 2. The investigations revealed acquired pure red cell aplasia. Workup for an associated underlying disorder was negative, ruling out secondary causes. The patient received corticosteroids as the standard treatment of primary acquired pure red cell aplasia, and he had a good response to treatment.
This case illustrates that acquired pure red cell aplasia might occur weeks after severe acute respiratory coronavirus 2 infection, suggesting that it might be considered a delayed complication of coronavirus disease 2019. The most relevant hypothesis of the pathogenesis of acquired pure red cell aplasia, in this case, is an immune mechanism triggered by infection with severe acute respiratory coronavirus 2 resulting in interruption of normal erythroid differentiation. We highlight the importance of follow-up care after the acute phase of coronavirus disease 2019 to spot late complications in order to successfully manage the secondary burden of the pandemic.
由严重急性呼吸综合征冠状病毒 2 引起的 2019 年冠状病毒病自 2019 年 12 月以来，导致了一场严重的大流行，导致全球数百万人死亡，而且这个数字还在不断增加。虽然 2019 年冠状病毒病主要是一种呼吸道综合征，但它被认为是一种多系统疾病，表现出广泛的临床表现，包括血液学特征。
我们介绍了一位阿拉伯男性，77 岁，在急性感染严重急性呼吸综合征冠状病毒 2 后 8 周出现严重贫血。检查显示获得性纯红细胞再生障碍。对相关潜在疾病的检查结果为阴性，排除了继发性原因。该患者接受了皮质类固醇治疗，作为原发性获得性纯红细胞再生障碍的标准治疗，他对治疗反应良好。
本病例说明获得性纯红细胞再生障碍可能在严重急性呼吸综合征冠状病毒 2 感染数周后发生，提示其可能被认为是 2019 年冠状病毒病的迟发性并发症。在这种情况下，获得性纯红细胞再生障碍发病机制的最相关假设是由严重急性呼吸综合征冠状病毒 2 感染引发的免疫机制导致正常红细胞分化中断。我们强调在 2019 年冠状病毒病的急性期后进行随访以发现晚期并发症的重要性，以便成功管理大流行的继发性负担。
