Severe autoimmune hemolytic anemia during pegylated interferon plus ribavirin treatment for chronic hepatitis C: a case report

Wang, Shasha; Qin, Eryun; Zhi, Yixiao; Hua, Rui

doi:10.1002/ccr3.1098

Cited by 7 publications

(4 citation statements)

References 8 publications

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“…An autoimmune basis is also postulated in HCV-related pulmonary fibrosis or porphyria (Aliannejad and Ghanei 2011 ). Furthermore, some autoimmune processes appear or are exacerbated during IFN-α-based treatment as a result of the immune-stimulatory properties of IFN (Dhillon et al 2010 ; Tsuchiya et al 2017 ; Wang et al 2017 ). DAA treatment is believed to be generally safer in individuals with chronic HCV infection and concomitant autoimmune disorders (Cacoub et al 2017 ; Yoshikawa et al 2017 ).…”

Section: Clinical Consequences Of the Impact Of Hcv On The Immune Sysmentioning

confidence: 99%

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Urbanowicz

Zagożdżon

Ciszek

2018

Arch. Immunol. Ther. Exp.

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The treatment of patients with chronic hepatitis C virus (HCV) infection has changed tremendously over the past 2 years, with an increasing variety of all-oral direct-acting antiviral (DAA) treatment regimens available for different HCV genotypes and distinct clinical settings. These treatments have significantly improved safety in patients with advanced liver disease compared with interferon (IFN)-based regimens. HCV modifies the human immune system to escape immunosurveillance via several mechanisms. One of the basic mechanisms of HCV is the ability to “switch” the immune response by reducing the activity of cells responsible for the elimination of virus-infected cells. IFN-free DAA treatment regimens provide a unique opportunity to assess the effect of HCV elimination on the immune system. Abrupt changes in the immune system can in some cases be responsible for two alarming processes: viral reactivation in patients with chronic hepatitis B and recurrence of hepatocellular carcinoma in patients with previous successful cancer treatment.

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Section: Clinical Consequences Of the Impact Of Hcv On The Immune Sysmentioning

confidence: 99%

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Urbanowicz

Zagożdżon

Ciszek

2018

Arch. Immunol. Ther. Exp.

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“…There are a positive correlation between interleukin-10 levels and reticulocyte counts, and a negative correlation between interleukin-10 and haptoglobin in hemolytic anemia [121]. Type 1 interferons including interferon alpha and interferon beta can trigger the disorder of autoimmune hemolytic anemia [122]. IgG1, the anti-viral THαβ immune related antibody, is related to the pathogenesis of autoimmune hemolytic anemia [116].…”

Section: Thαβ Immunological Pathway Related With Autoimmune Hemolytic...mentioning

confidence: 99%

<strong></strong>Type 2 Hypersensitivity Disorders including Systemic Lupus Erythematosus, Sjogren’s Syndrome, Grave’s Disease, Myasthenia Gravis, Immune Thrombocytopenia, Autoimmune Hemolytic Anemia, Dermatomyositis, and Graft versus Host Disease Are THab Dominant A

2024

Preprint

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Systemic lupus erythematosus (SLE) is a prevalent autoimmune condition, yet its alignment with a specific host immunological pathway remains unclear. The THαβ host immunological pathway, recognized for its defense against viruses and prions, has recently emerged as a response to DNA, RNA, and protein pathogens. SLE patients often produce anti-double strand DNA antibodies and anti-nuclear antibodies, suggesting a potential association with the THαβ host immune reaction. Throughout the course of SLE, elevated levels of type 1 interferons, type 3 interferons, interleukin-10, IgG1, and IgA1 are commonly observed. These cytokines and antibody isotypes are indicative of the THαβ host immunological pathway. Similarly, Myasthenia gravis, Grave’s disease, Graft versus host disease, autoimmune hemolytic anemia, immune thrombocytopenia, dermatomyositis, and Sjogren’s syndrome are also linked to THαβ-related type 2 hypersensitivities. Considering the potential association of these diseases with dysregulated THαβ immune responses, therapeutic strategies such as anti-interleukin-10 or anti-interferons α/β could be explored to manage these disorders effectively.

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“…Before the direct-acting antiviral agent (DAA) treatment era, AIHA was observed as an adverse event of interferon-based treatment [ 105 , 106 , 107 , 108 ], which could complicate drug-induced hemolytic anemia induced by ribavirin [ 109 , 110 , 111 ].…”

Section: Hepatic and Gastrointestinal Disorders Predisposing To Aumentioning

confidence: 99%

Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders

Bianco

Coluccio

Prati

et al. 2021

JCM

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Anemia is a common feature of liver and bowel diseases. Although the main causes of anemia in these conditions are represented by gastrointestinal bleeding and iron deficiency, autoimmune hemolytic anemia should be considered in the differential diagnosis. Due to the epidemiological association, autoimmune hemolytic anemia should particularly be suspected in patients affected by inflammatory and autoimmune diseases, such as autoimmune or acute viral hepatitis, primary biliary cholangitis, and inflammatory bowel disease. In the presence of biochemical indices of hemolysis, the direct antiglobulin test can detect the presence of warm or cold reacting antibodies, allowing for a prompt treatment. Drug-induced, immune-mediated hemolytic anemia should be ruled out. On the other hand, the choice of treatment should consider possible adverse events related to the underlying conditions. Given the adverse impact of anemia on clinical outcomes, maintaining a high clinical suspicion to reach a prompt diagnosis is the key to establishing an adequate treatment.

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Severe autoimmune hemolytic anemia during pegylated interferon plus ribavirin treatment for chronic hepatitis C: a case report

Cited by 7 publications

References 8 publications

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

Modulation of the Immune System in Chronic Hepatitis C and During Antiviral Interferon-Free Therapy

<strong></strong>Type 2 Hypersensitivity Disorders including Systemic Lupus Erythematosus, Sjogren’s Syndrome, Grave’s Disease, Myasthenia Gravis, Immune Thrombocytopenia, Autoimmune Hemolytic Anemia, Dermatomyositis, and Graft versus Host Disease Are THab Dominant A

Diagnosis and Management of Autoimmune Hemolytic Anemia in Patients with Liver and Bowel Disorders

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