Pure White Cell Aplasia and Necrotizing Myositis

Pure White Cell Aplasia and Necrotizing Myositis

Pure white cell aplasia (PWCA) is a rare hematologic disorder characterized by the absence of neutrophil lineages in the bone marrow with intact megakaryopoiesis and erythropoiesis. PWCA has been associated with autoimmune, drug-induced, and viral exposures. Here, we report a case of a 74-year-old f...

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Main Authors: Peter Geon Kim, Joome Suh, Max W. Adelman, Kwadwo Oduro, Erik Williams, Andrew M. Brunner, David J. Kuter
Format: Article
Language:English
Published: Hindawi Limited 2016-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2016/4161679
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spelling doaj-2bddf963b5bc4c579e43ec8c09380bca2020-11-25T00:14:07ZengHindawi LimitedCase Reports in Hematology2090-65602090-65792016-01-01201610.1155/2016/41616794161679Pure White Cell Aplasia and Necrotizing MyositisPeter Geon Kim0Joome Suh1Max W. Adelman2Kwadwo Oduro3Erik Williams4Andrew M. Brunner5David J. Kuter6Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Medicine, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Medicine, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Pathology, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Pathology, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Medicine, Massachusetts General Hospital, Boston, MA 02114, USADepartment of Hematology/Oncology, Massachusetts General Hospital, Boston, MA 02114, USAPure white cell aplasia (PWCA) is a rare hematologic disorder characterized by the absence of neutrophil lineages in the bone marrow with intact megakaryopoiesis and erythropoiesis. PWCA has been associated with autoimmune, drug-induced, and viral exposures. Here, we report a case of a 74-year-old female who presented with severe proximal weakness without pain and was found to have PWCA with nonspecific inflammatory necrotizing myositis and acute liver injury on biopsies. These findings were associated with a recent course of azithromycin and her daily use of a statin. Myositis improved on prednisone but PWCA persisted. With intravenous immunoglobulin and granulocyte-colony stimulating factor therapies, her symptoms and neutrophil counts improved and were sustained for months.http://dx.doi.org/10.1155/2016/4161679
collection DOAJ
language English
format Article
sources DOAJ
author Peter Geon Kim
Joome Suh
Max W. Adelman
Kwadwo Oduro
Erik Williams
Andrew M. Brunner
David J. Kuter
spellingShingle Peter Geon Kim
Joome Suh
Max W. Adelman
Kwadwo Oduro
Erik Williams
Andrew M. Brunner
David J. Kuter
Pure White Cell Aplasia and Necrotizing Myositis
Case Reports in Hematology
author_facet Peter Geon Kim
Joome Suh
Max W. Adelman
Kwadwo Oduro
Erik Williams
Andrew M. Brunner
David J. Kuter
author_sort Peter Geon Kim
title Pure White Cell Aplasia and Necrotizing Myositis
title_short Pure White Cell Aplasia and Necrotizing Myositis
title_full Pure White Cell Aplasia and Necrotizing Myositis
title_fullStr Pure White Cell Aplasia and Necrotizing Myositis
title_full_unstemmed Pure White Cell Aplasia and Necrotizing Myositis
title_sort pure white cell aplasia and necrotizing myositis
publisher Hindawi Limited
series Case Reports in Hematology
issn 2090-6560
2090-6579
publishDate 2016-01-01
description Pure white cell aplasia (PWCA) is a rare hematologic disorder characterized by the absence of neutrophil lineages in the bone marrow with intact megakaryopoiesis and erythropoiesis. PWCA has been associated with autoimmune, drug-induced, and viral exposures. Here, we report a case of a 74-year-old female who presented with severe proximal weakness without pain and was found to have PWCA with nonspecific inflammatory necrotizing myositis and acute liver injury on biopsies. These findings were associated with a recent course of azithromycin and her daily use of a statin. Myositis improved on prednisone but PWCA persisted. With intravenous immunoglobulin and granulocyte-colony stimulating factor therapies, her symptoms and neutrophil counts improved and were sustained for months.
url http://dx.doi.org/10.1155/2016/4161679
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