Control of Antibody-Mediated Pure Red-Cell Aplasia by Plasmapheresis

Abstract

THE development of acquired pure red-cell aplasia in some patients is based on autoimmune mechanisms,1 , 2 as indicated by a favorable clinical response to immunosuppressive therapy3 4 5 6 7 8 and by the presence of IgG autoantibodies that impair various stages and mechanisms of erythropoiesis.9 10 11 12 The effects include interference with heme synthesis,9 as demonstrated in suspension cultures of normal bone marrow, complement-dependent lysis of erythroblasts,3 , 9 and complement-independent inhibition of erythroid burst and colony formation in culture by early erythroid progenitors.13 14 15 16 Occasionally, antibodies are directed against erythropoietin.17 , 18 This report describes a patient with pure red-cell aplasia whose plasma contained antibodies that inhibited erythroid burst formation of . . .