Aplastic anemia with fetallike erythropoiesis following androgen therapy
AN Rao, AK Brown, RF Rieder, JB Clegg and WL Marsh
A 43/4-yr-old black girl with acquired aplastic anemia had an increase in
total hemoglobin (Hb) from 4.5 to 16.8 g/dl and fetal hemoglobin (HbF) from
0.8 g/dl (18.8%) to 9.6 g/dl (60.2%) following combined androgen-adrenal
steroid therapy. Discontinuation of the drugs was followed by a decline in
both HbF and total Hb. Reinstitution of the combined steroids prompted a
second rise in total and fetal hemoglobin. During these responses the
subject's erythrocytes exhibited an increased i antigen score and a low
level of red cell carbonic anhydrase. The glycine:alanine ratio at position
136 of the gamma chains of HbF was of the fetal type (proportion of chains
with glycine residues, 0.74). Hemoglobin A2 was low (0.4%). The synthesis
of alpha and non-alpha chains was balanced. These results indicate that the
stimulation of red cell proliferation in this subject, in response to
androgen therapy, resulted in the production of cells with several
characteristics of "fetal" erythrocytes.
Volume 51,
Issue 4,
pp. 711-719,
04/01/1978
Copyright © 1978 by The American Society of Hematology
