Isoniazid-triggered pure red cell aplasia in systemic lupus erythematosus complicated with myasthenia gravis

Rheumatol Int. 2010 Nov;30(12):1643-5. doi: 10.1007/s00296-009-1113-2. Epub 2009 Aug 25.


A 47-year-old woman who had been treated for systemic lupus erythematosus (SLE) with myasthenia gravis (MG) was admitted to our hospital with acute onset of severe anemia after administration of isoniazid. Pure red cell aplasia (PRCA) was confirmed by elevated serum iron levels, reticulocytopenia and bone marrow aspiration showing a remarkable reduction of erythroblasts. Finally, cyclosporine A successfully improved PRCA. Although both SLE and MG have the potential complication of PRCA, we report here a case of isoniazid-triggered PRCA.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / adverse effects*
  • Cyclosporine / therapeutic use
  • Drug Therapy, Combination
  • Erythroblasts
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Iron / blood
  • Isoniazid / adverse effects*
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / drug therapy*
  • Middle Aged
  • Myasthenia Gravis / complications
  • Myasthenia Gravis / drug therapy*
  • Red-Cell Aplasia, Pure / blood
  • Red-Cell Aplasia, Pure / chemically induced*
  • Red-Cell Aplasia, Pure / drug therapy
  • Reticulocyte Count
  • Reticulocytes / pathology
  • Treatment Outcome


  • Antitubercular Agents
  • Immunosuppressive Agents
  • Cyclosporine
  • Iron
  • Isoniazid