Severe acquired aplasic anemia associated with seronegative hepatitis. Case report

Main Article Content

Ángel Castro Dager
Karolay Dayana Mendoza Borja
Paola Andrea Manjarres Figueredo

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.

Downloads

Download data is not yet available.

Article Details

How to Cite
Castro Dager, Ángel, Mendoza Borja, K. D., & Manjarres Figueredo, P. A. (2024). Severe acquired aplasic anemia associated with seronegative hepatitis. Case report. Pediatría, 57(1), 4468. https://doi.org/10.14295/rp.v57i1.468
Section
Case report

References

Gonçalves V. Hepatitis-associated aplastic anaemia: A poor prognosis. BMJ Case Rep. 2013;2012–3. DOI: https://doi.org/10.1136/bcr-2012-007968

Clesham K. Diagnosis and management of childhood aplastic anaemia. Paediatrics and Child Health. 2019; 29: 327–333. DOI: https://doi.org/10.1016/j.paed.2019.05.001

Furlong E, Carter T. Aplastic anaemia: Current concepts in diagnosis and management. J Paediatr Child Health 2020. DOI: https://doi.org/10.1111/jpc.14996

Danewa A, Kalra M, Sachdeva A, Sachdeva P, Bansal D, Bhat S, et al. Diagnosis and Management of Acquired Aplastic Anemia: Consensus Statement of Indian Academy of Pediatrics. Indian Pediatr. 2022;59(6):467–75. DOI: https://doi.org/10.1007/s13312-022-2538-x

Ghanei-Shahmirzadi A, Reihani H, Abbasi-Kashkooli A, Karbasian F, Hedayati SB, Bordbar M, et al. Aplastic anemia: a new complication in the recent mysterious hepatitis outbreak among children worldwide: two case reports. J Med Case Rep [Internet]. 2022;16(1):1–5. Disponible en: https://doi.org/10.1186/s13256-022-03542-0. DOI: https://doi.org/10.1186/s13256-022-03542-0

Wang L, Liu H. Pathogenesis of aplastic anemia. Hematology. 2019 Dec;24(1):559-566. DOI: https://doi.org/10.1080/16078454.2019.1642548

Young NS. Aplastic Anemia. N Engl J Med. 2018 Oct 25;379(17):1643-1656. DOI: https://doi.org/10.1056/NEJMra1413485

Suzie A. Noronha; Aplastic and Hypoplastic Anemias. Pediatr Rev December 2018; 39 (12): 601–611. DOI: https://doi.org/10.1542/pir.2017-0250

Rauff B. Hepatitis associated aplastic anemia: a review. Virol J. 2011 Feb 28;8:87. DOI: https://doi.org/10.1186/1743-422X-8-87

Kemme S. Outcomes of Severe Seronegative Hepatitis-associated Aplastic Anemia: A Pediatric Case Series. J Pediatr Gastroenterol Nutr. 2021 Feb 1;72(2):194-201. DOI: https://doi.org/10.1097/MPG.0000000000002940

Böske AK, Sander A, Sykora KW, Baumann U, Pfister ED. Hepatitis-associated Aplastic Anaemia in Children. Klin Padiatr. 2020 May;232(3):151-158. DOI: https://doi.org/10.1055/a-1108-1553

Gonzalez-Casas R. Systematic review: hepatitis-associated aplastic anaemia--a syndrome associated with abnormal immunological function. Aliment Pharmacol Ther. 2009 Sep 1;30(5):436-43. DOI: https://doi.org/10.1111/j.1365-2036.2009.04060.x

Lorenz E, Quaiser K. Panmyelophatie nach hepatitis epidémica. Viena Med Wochenschr. 1955; 105 :19–22.

Patel KR. Features of Hepatitis in Hepatitis-associated Aplastic Anemia: Clinical and Histopathologic Study. J Pediatr Gastroenterol Nutr. 2017 Jan;64(1):e7-e12. DOI: https://doi.org/10.1097/MPG.0000000000001271

Similar Articles

<< < 1 2 3 4 5 

You may also start an advanced similarity search for this article.