Tacrolimus-Induced Pure Red Cell Aplasia Following Renal Transplantation: A Case Report and Literature Review

Anemia is common in end-stage renal disease, but it resolves rapidly after transplantation due to normalization of kidney function. Acquired pure red cell aplasia (PRCA) is an infrequent complication in kidney recipients. PRCA is a rare cause of profound anemia characterized by reticulocytopenia and marked reduction or absence of erythroid precursor. In this condition, all other cell lines are found in standard numbers and appear morphologically normal in the bone marrow. We herein report a case of a living-related kidney recipient who presented with severe anemia and developed PRCA associated with tacrolimus. The patient was successfully treated by switching tacrolimus to cyclosporine.