Long-term follow-up of hepatitis-associated aplastic anaemia

BMJ Case Rep. 2017 Dec 13:2017:bcr2017221434. doi: 10.1136/bcr-2017-221434.

Abstract

Prognosis of hepatitis-associated aplastic anaemia (HAAA) was improved with haematopoietic stem cell transplantation (HSCT) and immunosuppression, but the long-term outcome remains undefined. Case 1: a girl aged 3 years with acute liver failure (ALF) submitted to orthotopic liver transplantation (OLT) subsequently developed aplastic anaemia and HSCT from a compatible sibling was performed. Post-HSCT, the patient developed post-transplant lymphoproliferative disorder and rituximab was administered with good response. Fifteen years later, both grafts show good outcome. Case 2: a girl aged 10 years submitted to OLT due to ALF, developed pancytopenia 2 months later. Due to the absence of a human leucocyte antigen compatible donor, she was treated with ciclosporin and antithymocyte globulin with very good long-term outcome. These clinical cases suggest that, for patients with HAAA that underwent OLT, aggressive therapy with HSCT or immunosuppression may provide a benign long-term outcome.

Keywords: hepatitis other; malignant and benign haematology; transplantation.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / therapeutic use
  • Anemia, Aplastic / complications
  • Anemia, Aplastic / diagnosis*
  • Anemia, Aplastic / drug therapy
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Hepatitis / complications
  • Hepatitis / diagnosis*
  • Hepatitis / drug therapy
  • Humans
  • Liver Failure, Acute*
  • Liver Transplantation*
  • Postoperative Complications / diagnosis

Substances

  • Antiviral Agents
  • Acyclovir