Scleroderma Associated with Anemia and Thrombocytopenia that Responded Well to CyclosporinKamada K. · Kobayashi Y. · Katada K. · Takahashi Y. · Chikayama S. · Ikeda M. · Kondo M.
First Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
A 55-year-old woman came to our hospital because of cutaneous sclerosis of the limbs in September 1996, and was diagnosed with scleroderma based on a skin biopsy. In August 1997, the cutaneous sclerosis became progressive (hemoglobin level, 4.3 g/dl; platelet count, 7 × 109/l). The laboratory results were positive for the direct Coombs test, bone marrow aspiration showed a dry tap, and the bone marrow biopsy showed marked fatty marrow. Indium-111 bone marrow scintigraphy showed a markedly decreasing uptake. These findings indicated bone marrow hypoplasia associated with hemolytic anemia. After prednisolone therapy (60 mg) was initiated, the direct Coombs test became negative but the blood cell count did not increase. Then, 300 mg of cyclosporin was initiated and anemia and thrombocytopenia improved. The cyclosporin dosage was gradually decreased and the patient’s hematological condition was good, although the cutaneous sclerosis changed only a little. This is a rare and interesting case of a patient with scleroderma associated with bone marrow insufficiency and hemolysis who responded well to cyclosporin.
First Department of Internal Medicine, Kyoto Prefectural University of Medicine
Kawaramachi Hirokoji Kamigyo-ku, Kyoto 602 0841 (Japan)
Tel. +81 75 251 5505, Fax +81 75 252 3721
Received: Received: November 19, 1999
Accepted: May 25, 2000
Number of Print Pages : 4
Number of Figures : 4, Number of Tables : 0, Number of References : 16
Affiliated with Molecular Biology of Hematopoiesis Symposium
Vol. 104, No. 2-3, Year 2000 (Cover Date: Released January 2001)
Journal Editor: I. Ben-Bassat, Tel Hashomer
ISSN: 0001–5792 (print), 1421–9662 (Online)
For additional information: http://www.karger.com/journals/aha