RIFAMPICIN INDUCED PURE RED CELL APLASIA

Background Pure red cell aplasia (PRCA) is a rare condition of severe anemia characterized by an absence of erythroid precursor in the bone marrow, severe reticulocytopenia and normal platelet and leukocyte count. This condition appears as an acquired defect of either acute or chronic type, and a congenital form. The acquired form occurs in association with autoimmune or lymphoproliferative disorders, and we discover thymoma in 5% of patients. The acute acquired form is associated with some hemolytic disorders, infections and may occur with the use of certain drugs. Patient and methods The article presents a 53-year old patient who developed a severe form of anemia with methods reticulocytopenia while he was being treated with vancomycin and rifampicin antibiotics. Because of the end stage renal failure he is on chronic hemodyalisis and is treated with erythropoietin. He is also infected by hepatitis C virus. The virtual absence of erythroid precursor in the bone marrow lead us to presume a PRCA. The other causes of anemia were ruled out with the absence of antibodies against erythropoietin and Ig M antibodies to parvovirus B 19. After withdrawal of treatment with antibiotics and introduction of treatment with immunoglobulins the patient completely recovered and is anemia-free. Conclusions During the course of infections anemia could be the consequence of treatment with antibiotics and other drugs. The diagnosis is confirmed predominantly by bone marrow examination.