Elderly Male With Epstein-Barr Virus (EBV)-Induced Pure Red Cell Aplasia

Area of Science:

• Hematology
• Virology
• Immunology

Background:

• Pure red cell aplasia (PRCA) is a rare disorder characterized by anemia with normal white blood cell and platelet counts.
• Acquired PRCA in adults is often linked to autoimmune conditions, infections, or malignancies.
• Epstein-Barr virus (EBV) has been implicated in PRCA, typically in patients with underlying cancers.

Observation:

• A previously healthy elderly male presented with symptomatic, transfusion-dependent anemia.
• Bone marrow examination revealed selective erythroid hypoplasia, consistent with PRCA.
• The patient had no evidence of underlying malignancy or other significant comorbidities.

Findings:

• Epstein-Barr virus (EBV) infection was identified as the likely cause of PRCA in this patient.
• The patient's anemia demonstrated a significant response to a treatment regimen including glucocorticoids, rituximab, and intravenous immunoglobulins.
• This case suggests EBV can induce PRCA even in the absence of malignancy.

Implications:

• This case expands the known spectrum of EBV-associated hematologic disorders.
• It underscores the importance of considering EBV in the differential diagnosis of acquired PRCA, particularly in elderly individuals.
• The successful treatment with immunotherapy suggests a potential therapeutic strategy for similar cases.