A 20-year-old woman, with body weight 46 kg was diagnosed as having MDR-TB plus resistance to fluoroquinolone and was treated with linezolid-containing regimen (cycloserine 750 mg, clofazimine 100 mg, linezolid 600 mg (13 mg/kg body weight), bedaquiline 200 mg). She had no other disease and was not taking any other medication. Before starting MDR-TB treatment, her hemoglobin (Hb) level was 12.1 gr/dL, neutrophil and platelet count were 3450/ml and 298,000/ml respectively. She developed severe anemia (Hb level 5.5 g/dL) at 12th week of treatment, accompanied with declining neutrophil and platelet count (1570/ml and 254,000/ml, respectively). No other causes of anemia were found. She was hospitalized and had 4 packed red cell transfusion. Linezolid was stopped and delamanid 100 mg bid was started. Four weeks after linezolid was stopped, her Hb level was 12.7 gr/dL, neutrophil and platelet count were 2180 /ml and 280,000/ml, respectively. GDF-15 level was normal at baseline: 1189.52 pg/ml (normal 200 -1200 pg/ml), and markedly elevated to 4108.88 pg/ml at 2nd week of linezolid treatment.