Hepatitis-associated aplastic anemia

Alshaibani, Alfadel; Dufour, Carlo; Risitano, Antonio M.; Latour, Regis de; Aljurf, Mahmoud

doi:10.1016/j.hemonc.2020.10.001

Cited by 22 publications

(43 citation statements)

References 40 publications

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“…Several viral infections are documented to be associated with HAAA. Nonetheless, in many cases, a causative agent cannot be identified 1 4. HAAA is a potentially lethal disease and treatment follows similar protocol as with classical AA.…”

Section: Discussionmentioning

confidence: 99%

“…Several hepatotropic and non-hepatotropic viruses such as hepatitis A, B, C, E and G and others such as parvovirus B19, human herpes viruses (HHV), Ebstein-Barr virus (EBV) and cytomegalovirus (CMV) are associated with HAAA 3. Nonetheless, only 6% HAAA cases have an identifiable viral aetiology, while the majority are idiopathic cases without clear aetiology of liver injury 4. To date only two reports of HAAA secondary to toxic hepatitis due to consumption of muscle building protein and work-out supplements are reported in literature 5 6.…”

Section: Introductionmentioning

confidence: 99%

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Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use

2022

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Hepatitis-associated aplastic anaemia (HAAA) is a rare condition characterised by onset of acute hepatitis which is followed by development of severe pancytopenia due to bone marrow failure within 6 months. This syndrome can be precipitated by acute viral infections, but the aetiology remains unknown in the majority. Drug-induced HAAA is extremely rare and has been reported with nutritional and dietary supplements in current literature. We report the first cases of ayurvedic herbal and homeopathic remedies-associated HAAA in two patients which proved fatal in both. Evaluation of patients with acute hepatitis and severe pancytopenia must include a detailed evaluation for complementary and alternative medicine use.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use

2022

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“…Hepatitis-associated aplastic anemia (HAAA) is a well-recognized and rare phenomenon, de ned as pancytopenia and hypocellular marrow occurring two to three months after an acute hepatitis episode. The condition has been reported in all the hepatotropic virus infections including hepatitis A (HAV), B (HBV),C (HCV) ,D (HDV), E (HEV) and G (HGV) viruses (35). However, in most cases of HAAA no HAV, HBV, HCV association is found.…”

Section: Aplastic Anemiamentioning

confidence: 99%

A Meticulous Review of Diverse Etiologies and Pathophysiology of Anemia in Chronic Liver Disease

Azadeh

2022

Preprint

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Background Anemia in chronic liver diseases is a common condition with a wide variety of etiologic factors, some of which are life-threatening and need immediate evaluation and intervention. Furthermore, the severity of anemia has been associated with a poor disease prognosis and quality of life of patients. Herein, we have investigated the current literature regarding the spectrum of anemia in advanced liver diseases. Results Anemia of chronic disease, gastrointestinal bleeding, malnutrition, iron deficiency anemia and hypersplenism are the common etiologies of anemia accompanied by liver diseases. Medication side effects, viral-induced aplastic anemia and alcohol related hematologic abnormalities constitute the other parts of spectrum of anemia in liver diseases. Conclusion Among the various mechanisms of anemia in liver diseases, some are life-threatening and some can be controlled. Investigation of etiology of anemias in chronic liver diseases is recommended, as disease-specific treatments will ameliorate the anemia and enhance patients’ quality of life.

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“…Aplastic anemia (AA) is a disorder characterized by bone marrow hematopoietic failure and pancytopenia [ 1 ]. Hepatitis-associated aplastic anemia (HAAA) is a specific type of AA, manifested as pancytopenia within 6 months after the onset of acute hepatitis [ 2 ]. Compared to acquired idiopathic AA, the degree of bone marrow failure in HAAA is often more obvious, manifested mainly as severe aplastic anemia (SAA), very severe aplastic anemia (VSAA), or even fulminant aplastic anemia (FAA).…”

Section: Introductionmentioning

confidence: 99%

“…Compared to acquired idiopathic AA, the degree of bone marrow failure in HAAA is often more obvious, manifested mainly as severe aplastic anemia (SAA), very severe aplastic anemia (VSAA), or even fulminant aplastic anemia (FAA). Hematopoietic stem-cell transplantation (HSCT) is a crucial treatment for AA, especially for SAA, recommended as the first-line treatment for patients with HAAA [ 1 , 2 ]. In spite of its high cure rate, HSCT has its limitations and complications, including infections, sinus occlusion syndrome (SOS), graft-versus-host disease (GVHD), and engraftment failure, which may lead to transplant failure and even death [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Acute rhabdomyolysis in hepatitis-associated aplastic anemia patient undergoing allogeneic hematopoietic stem-cell transplantation: case report and literature review

Hong

Shen

et al. 2022

Eur J Med Res

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Background Hepatitis-associated aplastic anemia (HAAA) is a specific type of aplastic anemia, and hematopoietic stem-cell transplantation (HSCT) is recommended as the first-line. Acute rhabdomyolysis (AR) during hematopoietic stem-cell transplantation (HSCT) is a rare, serious complication, with only 10 cases reported in the world so far. Case presentation Herein, we present a case of AR developing during HLA-haploidentical HSCT in a 55-year-old man who suffered from HAAA. On day 7 after stem cell transfusion, the patient reported a muscle pull in thigh and complained of muscle swelling, pain and change in urine color. Despite the timely diagnosis (based on the levels of myoglobin and creatine kinase, and muscle MRI findings, etc.) and rapid hydration and alkalization, the situation progressed dramatically, and the patient died of multi-organ failure during the preparation for continuous renal replacement therapy (CRRT). Five days after his death, the whole-exome sequencing result confirmed that the patient had a germline missense mutation in SCN4A I 1545 V and ACTN3 R577X. Conclusion AR is a rare but threatening complication during HSCT, especially in cases with kidney dysfunction. The creatine kinase level may not truly and completely reflect the severity and prognosis for cases with localized lesion. We suggest that genetic analysis should be performed for better understanding the pathological changes of AR during HSCT, especially for patients with bone marrow failure.

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Hepatitis-associated aplastic anemia

Cited by 22 publications

References 40 publications

Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use

Toxic hepatitis-associated aplastic anaemia after dual homeopathic remedies and Gymnema sylvestre use

A Meticulous Review of Diverse Etiologies and Pathophysiology of Anemia in Chronic Liver Disease

Acute rhabdomyolysis in hepatitis-associated aplastic anemia patient undergoing allogeneic hematopoietic stem-cell transplantation: case report and literature review

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