Autoimmune Hemolytic Anemia with Reticulocytopenia and Erythroid Marrow

IN the course of a hemolytic disorder, episodes may occur during which reticulocytes virtually disappear from the blood, with the result that uncompensated destruction of red cells leads to progressively severe anemia.“Aplastic crises” were first described in hereditary spherocytosis¹ and have been observed in many other hemolytic states, including autoimmune hemolytic anemia (AIHA).^{2 3 4 5 6 7} Often attributable to intercurrent infection, the episodes are usually brief and characterized by transient absence of red-cell precursors from the marrow. In some cases of AIHA, there are prolonged periods of reticulocytopenia, at times accompanied by leukopenia, thrombocytopenia, and hypoplastic marrow.^{8 9 10} In other cases, severe reticulocytopenia. . .