Pure Red Cell Aplasia Caused by Azathioprine

Background: Pure Red Cell Aplasia (PRCA) is a clinical entity comprising severe normochromic normocytic anemia, reticulocytopenia, erythroblastopenia in the bone marrow, with normal leukocyte and platelets count. PRCA can be classified into congenital and acquired, with the latter characterized as idiopathic or secondary to various infections, hematological malignancies, collagen vascular diseases, thymoma, and exposure to a variety of drugs and other chemical substances. Methods: Herein, we present a female patient, who presented with PRCA due to azathioprine treatment. Results: Prompt discontinuation of the drug together with red blood cells transfusions led to complete recovery in this young patient, without any addition of immunosuppressive regimen. Conclusion: We followed ‘the wait and see practice’ instead of administering immunosuppression to our patient, after careful consideration and extensive consultation with our hematologists. This ‘wait and see practice’ proved to be effective in the long run.