hematology and oncology
Pure Red Blood Cell Aplasia
Diagnosis of Pure Red Blood Cell Aplasia
Complete blood count (CBC), reticulocyte count Bone marrow examination Peripheral blood smear looking for large granular lymphocytes Sometimes peripheral blood flow cytometry and T cell gene rearrangement testing Pure RBC aplasia manifests with a normocytic anemia but normal white blood cell and platelet counts. Reticulocytes are decreased (absolute reticulocyte count < 10,000/microliter, reticulocyte percentage < 1%). The bone marrow reveals normal cellularity with a maturation arrest at the proerythroblast stage. In parvovirus B19 infection, giant pronormoblasts may be present. Although not widely available, if possible, a marrow burst forming units-erythroid (BFU-E) assay should be obtained to differentiate autoimmune causes of pure red cell aplasia from primary bone marrow disorders such as Myelodysplastic Syndrome (MDS) ( Chest CT is indicated to evaluate for thymoma in the absence of another identified cause. 1.DeZern AE, Pu J, McDevitt MA, et al: Burst-forming unit–erythroid assays to distinguish cellular bone marrow failure disorders.Exp Hematol41:808–816, 2013. 