ACQUIRED IDIOPATHIC PURE RED-CELL APLASIA IN A HEMODIALYZED PATIENT WITH INACTIVE SYSTEMIC LUPUS-ERYTHEMATOSUS

A male patient suffered chronic renal failure due to lupus nephritis a nd was undergoing hemodialysis. Six years after beginning hemodialysis , anemia developed, which improved by erythropoietin. Unresponsiveness to erythropoietin gradually appeared, and with a suspicion of pure re d cell aplasia, he was treated with a high-dose corticosteroid but the unresponsiveness did not improve. Neither his serum nor lymphocytes i nhibited erythropoiesis of either normal bone marrow stem cells or his own in vitro. These observations suggest an impaired hematopoietic mi croenvironment in his bone marrow.