First case report of acquired pure red cell aplasia associated with micafungin

Intern Med. 2011;50(9):1051-4. doi: 10.2169/internalmedicine.50.4303. Epub 2011 May 1.

Abstract

A 70-year-old Japanese man with chronic kidney disease under treatment with oral prednisolone for organizing pneumonia developed pulmonary aspergilloma. The patient was started on micafungin (MCFG), with no addition of any other new drug. About 5 weeks later, aggravation of his normocytic anemia associated with a low reticulocyte count was observed. Bone marrow puncture and biopsy revealed intense hypoplasia of the erythroblasts. As there was no evidence of malignancy, human parvovirus B19 infection, autoimmune diseases or hemorrhage, the patient was diagnosed as having acquired pure red cell aplasia (PRCA). The anemia improved along with an increase of the reticulocyte count to the normal level within 12 weeks of discontinuation of the MCFG therapy. The patient showed no evidence subsequently of any recurrence of the normocytic normochromic anemia or relapse of the PRCA. This is the first reported case of PRCA associated with MCFG.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antifungal Agents / adverse effects*
  • Bone Marrow / pathology
  • Cryptogenic Organizing Pneumonia / drug therapy
  • Echinocandins / adverse effects*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Lipopeptides / adverse effects*
  • Male
  • Micafungin
  • Prednisolone / adverse effects
  • Pulmonary Aspergillosis / drug therapy
  • Red-Cell Aplasia, Pure / blood
  • Red-Cell Aplasia, Pure / chemically induced*
  • Red-Cell Aplasia, Pure / pathology

Substances

  • Antifungal Agents
  • Echinocandins
  • Immunosuppressive Agents
  • Lipopeptides
  • Prednisolone
  • Micafungin