Severe acquired aplasic anemia associated with seronegative hepatitis. Case report
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Abstract
Background: Aplastic anemia is a life-threatening condition that refers to a hypocellular or acellular bone marrow associated with pancytopenia, of genetic or acquired cause. Seronegative autoimmune hepatitis is a rare cause related to marrow aplasia that is recognized by a marked increase in liver enzymes; its treatment is based on steroids, immunomodulators and hematopoietic cell transplantation. Case report: A 12-year-old male who presented with bruising and skin pallor for a month. Initial paraclinical tests revealed pancytopenia and a severe increase in transaminases. A bone marrow biopsy was performed, which reported hypocellularity, marrow aplasia was diagnosed, and follow-up was initiated in the transplant unit. He received treatment with prednisone and azathioprine, with resolution of hepatitis, and subsequently received a successful bone marrow transplant from a similar allogeneic donor. Conclusions: Seronegative autoimmune hepatitis is a very rare cause of aplastic anemia that should be considered in the differential diagnoses of a patient with pancytopenia and liver function changes. Timely management of liver damage with immunomodulatory therapy and care in the transplant unit can improve clinical results and survival.
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