Erythrocyte Aplasia and Hypogammaglobulinemia

Abstract

A case of erythrocyte hypoplasia and hypogammaglobulinemia with no apparent etiology in a young man is described. This patient had 3 separate relapses and remissions induced by prednisone over a 2 1/2 year period, and was still in remission 4 1/2-years after the illness began on a daily maintenance dose of prednisone 5 mg/day. A series of bone marrow studies taken during remission and relapse revealed absence of plasma cells. In the 3rd relapse, serial electrophoretic patterns were run during the period of prednisone therapy. As the reticulocytes appeared and increased in number, the gamma globulin rose to a level slightly below normal. During relapse the erythro-poietin levels were reported to be extremely high, and the radioactive iron turnover was extremely low. It is felt that this case presents with 2 basic cellular defects, erythroid and plasmacellular, with resulting anemia and hypogammaglobulinemia. These combined defects may indicate some more fundamental genetic abnormality.