ISSN 2997-1036
International Journal of Hematology | Vol. 1, No. 5, May 2010 | pp. 33–40
DOI: 10.46882/2010/IJH/000005
Case Report
Title: Successful management of severe acquired pure red cell aplasia associated with thymoma in an elderly patient
Names of Authors: W. X. Ibrahim¹, Y. Z. Garba², A. A. Lawal³
Authors’ Affiliations: ¹Department of Internal Medicine, Federal Medical Centre, Gusau, Nigeria; ²Department of Pathology, Usmanu Danfodiyo University, Sokoto, Nigeria; ³Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
Abstract: Acquired pure red cell aplasia is a rare bone marrow failure syndrome characterized by severe normocytic anemia, profound reticulocytopenia, and marked reduction of erythroid precursors. We report a 68-year-old male presenting with severe fatigue, hemoglobin of 4.2 g/dl, and absolute absence of bone marrow erythropoiesis. Chest computed tomography revealed an anterior mediastinal mass measuring 6.2 × 4.8 cm. Histopathological examination post-thymectomy confirmed a type B1 thymoma. Cyclosporine-A therapy combined with low-dose corticosteroids was initiated post-operatively due to persistent reticulocytopenia. Hematologic recovery commenced by week 6, achieving normalization of hemoglobin values (13.5 g/dl) by month 4 of combined immunomodulatory management. The patient remained in complete hematologic remission at the 12-month post-operative follow-up. This case highlights the importance of thorough mediastinal screening in adult-onset pure red cell aplasia and demonstrates that surgical thymectomy paired with tailored immunosuppression yields excellent long-term survival and hematopoietic recovery in elderly patients.
Keywords: Pure red cell aplasia, thymoma, immunosuppression, cyclosporine, anemia
Manuscript Timeline: Received: February 10, 2010; Revised: March 22, 2010; Accepted: April 12, 2010; Published: May 19, 2010