Pure red cell aplasia associated with fenoprofen

Area of Science:

• Hematology
• Pharmacology
• Internal Medicine

Background:

• Drug-induced anemias are a recognized adverse effect of various medications.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation.
• Pure red cell aplasia (PRCA) is a rare condition characterized by the selective failure of erythropoiesis.

Observation:

• A 69-year-old male patient presented with symptoms suggestive of anemia.
• The patient had been taking fenoprofen, an NSAID, for ten months for an unspecified condition.
• The patient had a history of treated lung carcinoma, which was considered and ruled out as the cause of the anemia.

Findings:

• The patient was diagnosed with pure red cell aplasia (PRCA).
• The erythroid defect completely reversed upon discontinuation of fenoprofen.
• This case is the third reported instance of PRCA associated with an anti-inflammatory agent and the first linked to fenoprofen.

Implications:

• Fenoprofen can induce pure red cell aplasia (PRCA) in susceptible individuals.
• Discontinuation of the offending drug is crucial for the management of drug-induced PRCA.
• This finding expands the spectrum of known adverse hematologic effects associated with NSAIDs.