Refractory anaemia in an immunocompromised patient--what is it?

Anaemia is common among human immunodeficiency virus (HIV)-infected patients. It may be directly attributable to the virus or may be caused by opportunistic infections, neoplasms or drugs that cause either bone marrow suppression or haemolysis. Pure red cell aplasia (PRCA) is an uncommon haematological disorder that causes severe transfusion dependant anaemia. We report a 36 year-old female with HIV infection who developed anaemia which did not improve even after discontinuing the offending drug, namely Zidovudine. Routine investigations were unhelpful but her bone marrow study was consistent with pure red cell aplasia. She showed dramatic improvement with steroids with subsequent transfusion independence.