A CASE-REPORT OF A PATIENT WHO HAS PURE RED-CELL APLASIA AND RHEUMATOID-ARTHRITIS

Pure red cell aplasia (PRCA) as an extra-articular manifestation of rh eumatoid arthritis (RA) is rare. In the present report a 40-year-old f emale patient, with a 4-year-history of severe anemia and pain in the small joints of the hands, was diagnosed as having PRCA by bone marrow (BM) examination. Antithymocyte globulin (ATG), methylprednisolone an d cyclosporin A (CSA) were used for the treatment of PRCA. The patient 's hematological values responded within 6 months but pre-existing art hralgia continued, although with some relief. The patient subsequently fulfilled the criteria for diagnosis of RA at the 16th month. A revie w of nine published case reports on the coexistence of PRCA with RA re vealed the initial diagnosis as RA. In our case, as the initial sympto ms and findings were not sufficient for the diagnosis of RA, we theref ore conclude that PRCA preceded RA. Although CSA was curative in the t reatment of PRCA it could not prevent the full diagnostic features of RA. (C) 1997 Elsevier Science Ireland Ltd.