[Successful gamma-globulin pulse therapy of a young child with acquired pure red cell aplasia]

We report a case of a 2 years and 2 months old male, who showed a normochromic normocytic anemia, Hb 3.7g/dl. The bone marrow aspiration revealed a remarkable decrease of erythroblasts alone. Because of none of other underlying diseases identified, it leads to a diagnosis of acquired idiopathic pure red cell aplasia (PRCA). Pulse therapy of methylprednisolone, followed by one month administration of prednisone did not lead to a remission. However, high dose of gamma-globulin pulse therapy restored erythropoiesis in several days, with a rate of hemoglobin increment of 0.5 g/dl/day. 2.5 years after the onset of PRCA, the patient has neither suffered from complications of hematological diseases, nor undesired consequences of the therapy. Although recent advance of therapy regarding PRCA has focussed on cyclosporine A, high dose of gamma-globulin pulse therapy with a remarkable effect is worth as an alternative.