[Ineffective cortico-sensitive erythropoiesis in 2 young adults]

A 21 year-old man and a 17 year-old woman presented with severe anemia of unknown etiology. The bone marrow aspiration showed many erythroblasts which were morphologically normal, but there was no reticulocytosis; the 59Fe kinetics were typical of a major ineffective erythropoiesis. A rapid and total improvement occurred following steroid treatment. In the first case, there was a transient and cortico-responsive thrombocytopenia before and after the anemia and in the second case, the antiglobulin test was sometimes weakly positive. An immunological disturbance against the late erythroblasts is likely. Perhaps these case are not very different from those reported as "hemolytic anemia with reticulocytopenia".