Isoniazid-induced Pure Red Cell Aplasia in a Patient with Sarcoidosis: A Patient Summary and Review of the Literature

Intern Med. 2017 Oct 15;56(20):2753-2757. doi: 10.2169/internalmedicine.8379-16. Epub 2017 Sep 15.

Abstract

A 41-year-old woman treated with isoniazid (INH) for latent tuberculosis infection and an oral corticosteroid for sarcoidosis developed severe anemia two months after initiating INH. A bone marrow examination showed erythroblastopenia, and a diagnosis of INH-induced pure red cell aplasia (PRCA) was made. Her reticulocyte count and hemoglobin levels improved two weeks after discontinuation of INH. A literature review of INH-induced PRCA shows that it occurs very rarely in the context of autoimmune disorders. This report describes a case of INH-induced PRCA occurring in a patient with sarcoidosis.

Keywords: autoimmune disorders; biological drug; isoniazid; latent tuberculosis infection; pure red cell aplasia; sarcoidosis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Antitubercular Agents / administration & dosage*
  • Antitubercular Agents / therapeutic use
  • Female
  • Humans
  • Isoniazid / adverse effects*
  • Isoniazid / therapeutic use
  • Latent Tuberculosis / complications
  • Latent Tuberculosis / drug therapy*
  • Red-Cell Aplasia, Pure / chemically induced*
  • Sarcoidosis / complications
  • Sarcoidosis / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Antitubercular Agents
  • Isoniazid