Membrane Bound IgG on Erythroblasts in Pure Red Cell Aplasia following Thymectomy

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Abstract
A case of pure red cell aplasia appearing 6 mo. following thymectomy is reported in a 43 yr old man. Immunofluorescence studies of the patient''s bone marrow demonstrated the presence of membrane-bound IgG [immunoglobulin G] on the majority of erythroblasts and some mature erythrocytes. The IgG represents anti-erythroid autoantibodies. The number of Ig-bearing lymphocytes in peripheral blood was decreased as was the level of Ig indicating a B[bone marrow-derived]-lymphocyte deficiency. T[thymus-derived]-lymphocyte functions were normal. The patient was initially treated with corticosteroids and oxymetholone. He responded well to this therapy but relapsed 9 mo. later. Cyclophosphamide treatment was started and was followed by a complete hematologic remission.