Hepatitis-associated aplastic anaemia: a poor prognosis

Gonçalves, Vivian; Calado, Rita; Palaré, Maria João; Ferrão, Anabela; Morais, Anabela

doi:10.1136/bcr-2012-007968

Cited by 7 publications

(11 citation statements)

References 9 publications

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“…Patients with HAAA develop severe pancytopenia weeks to months after an acute episode of self-relief hepatitis. The mean survival time after developing severe bone marrow aplasia is 2 months, and the fatality rate ranges from 78% to 88% ( 10 ). The treatment options for HAAA are IST and allogeneic HSCT.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with HLA-matched peripheral hematopoietic stem cell transplantation for very severe hepatitis-associated aplastic anemia complicated with multidrug-resistant bacterial and fungal infections: A case report

Chen

et al. 2022

Front. Pediatr.

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Hepatitis-associated aplastic anemia (HAAA) is a life-threatening hematologic disorder characterized by bone marrow failure. Allogeneic hematopoietic stem cell transplantation (HSCT) is the first-line treatment for HAAA. Severe infection and complications in patients with very severe aplastic anemia are the challenges to the efficacy of HSCT. We report a rare case of successful transplantation with HLA-matched peripheral hematopoietic stem cells for a 15-year-old girl suffering from HAAA with multidrug-resistant bacterial and fungal infections. Through effectively controlling infection and optimal timing of transplantation by adjusting the conditioning regimen, the allo-HSCT was successfully performed for the patient. Updated data of following-up 26 months after transplantation showed that the patient was still in complete remission with a good quality of life. This case provided a reference for treating severely infected patients with HAAA before HSCT.

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Section: Discussionmentioning

confidence: 99%

Successful treatment with HLA-matched peripheral hematopoietic stem cell transplantation for very severe hepatitis-associated aplastic anemia complicated with multidrug-resistant bacterial and fungal infections: A case report

Chen

et al. 2022

Front. Pediatr.

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“…A BM failure can be rapid and severe and is usually fatal if untreated. The mean survival time after developing severe BM aplasia is 2 months, and the fatality rate ranges from 78% to 88% 8 . The pathogenesis of HAAA remains unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have demonstrated that the expansion of a liver-infiltrating cytotoxic T lymphocyte clone takes part in the development of HAAA, especially CD8 + cells might be important mediators of HAAA. Immunosuppressive therapy such as antithymocyte globulin (ATG) and cyclosporine has been reported to be effective, without eliciting any acute side effects 8 , 15 .…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a 19-Month-Old Boy with Hepatitis Associated Aplastic Anemia by Infusion of Umbilical Cord-Derived Mesenchymal Stromal Cells: A Case Report

Liu

Lim²,

Guo

et al. 2021

Cell Transplant

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Here we presented a case of a 19-month-old boy who developed severe aplastic anemia postacute hepatitis. He was treated successfully with the umbilical cord-derived mesenchymal stromal cells (UC-MSCs) infusion and cyclosporine A (CsA). The boy achieved both hematopoietic recovery and normal lymphocyte proportion. So far, his condition still remains stable. To our knowledge, there is a rare previous report on the utility of MSCs infusion for the treatment of hepatitis-associated aplastic anemia (HAAA). Considering the efficacy, safety, and strong operability, particularly for pediatric patient, the infusion of UC-MSCs combined with CsA could be an effective alternative for the treatment of HAAA.

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“…36,38 However, an earlier onset is not uncommon in literature, and patients can still have laboratory features of acute hepatitis on presentation with HAAA. 42 In fact, according to a study in bone marrow transplant patients by Safadi et al, around 40% of patients who develop HAAA still have the laboratory markers of hepatitis on diagnosis. 41 At the opposite extreme, HAAA can also be observed in 10% of patients after more than 1 year from a hepatitis episode.…”

Section: Aplastic Anemiamentioning

confidence: 99%

“…Cyclosporine and antithymocyte immunoglobulin (ATG) are the treatments of choice. 37,42 Cases of simultaneous improvement of hepatitis features and pancytopenia after the initiation of immunosuppressive treatment imply that the exact immune-mediated mechanism can be responsible for both hepatic and bone marrow injury. 37 Clinical data seem to confirm that, compared with the general population of patients with AA, patients with HAAA have similarly favorable results of bone marrow transplantation and immunosuppressive therapy.…”

Section: Aplastic Anemiamentioning

confidence: 99%

Rare causes of anemia in liver diseases

Dawidowski¹,

Pietrzak²

2022

Adv Clin Exp Med

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Anemia is a common finding among patients with liver diseases. Patients who suffer from anemia are at a higher risk of liver function decompensation and hospitalization. It affects significantly their quality of life and contributes to mortality. Anemia is present in 70% of patients with liver cirrhosis and with varying incidence accompanies other liver disorders. As the etiology of anemia in liver diseases is multifactorial, various cases represent different clinical entities. Anemia accompanying hepatic disorders can be broadly divided into several types, such as anemia associated with blood loss, as well as aplastic, hemolytic and micronutrient deficiency anemia. However, it is sometimes difficult to delineate between those types in the clinical practice, as several pathophysiological causes can be present in one patient. It is reported that the most common cause of anemia in liver disease is blood loss and iron deficiency. Still, the incidence of unclear cases reaching over 50% suggests that other types of anemia can be underdiagnosed. This review comprehensively describes less frequent types of anemia associated with liver disease, namely hemolytic and aplastic anemia (AA). Hemolytic anemia can complicate autoimmune liver diseases or be a manifestation of membranopathy of red blood cells, dependent on severe hepatic function impairment or alcoholic liver disease. Aplastic anemia is best known as a sequela of viral hepatitis, but some degree of bone marrow inhibition can complicate virtually all advanced liver diseases.

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Hepatitis-associated aplastic anaemia: a poor prognosis

Cited by 7 publications

References 9 publications

Successful treatment with HLA-matched peripheral hematopoietic stem cell transplantation for very severe hepatitis-associated aplastic anemia complicated with multidrug-resistant bacterial and fungal infections: A case report

Successful treatment with HLA-matched peripheral hematopoietic stem cell transplantation for very severe hepatitis-associated aplastic anemia complicated with multidrug-resistant bacterial and fungal infections: A case report

Successful Treatment of a 19-Month-Old Boy with Hepatitis Associated Aplastic Anemia by Infusion of Umbilical Cord-Derived Mesenchymal Stromal Cells: A Case Report

Rare causes of anemia in liver diseases

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