Hepatitis C virus-induced leuko-thrombocytopenia and haemolysis

Abstract

Hepatitis C virus (HCV) has been recognized as the cause of thrombocytopenia occurring in patients with chronic hepatitis C, possibly through autoimmune mechanisms. A patient is described with B cell chronic lymphocytic leukaemia, presenting with a marked leuko-thrombocytopenia and an associated mild haemolysis secondary to HCV infection, in the absence of clinical and biochemical signs of hepatitis. Anti-HCV antibodies were detected in the serum both by ELISA and RIBA but not 2 months before the onset of cytopenia. The presence of HCV RNA was documented both in the peripheral blood mononuclear cells and in the bone marrow by reverse transcriptase polymerase chain reaction of the 5' untranslated region of the viral genome. Of interest, HCV RNA was also found in the serum, showing that viraemia was associated with the presence of circulating anti-HCV antibodies. HCV genotyping, performed by PCR amplification of the core region, revealed the presence of an unclassifiable genotype. The hypothetical mechanisms leading to HCV-induced cytopenia in this patient are briefly discussed. Treatment with corticosteroids was effective in controlling blood cell counts, without increasing viraemia and deterioration of liver disease. HCV infection should be considered in the differential diagnosis of possible causes of cytopenia, mainly in immunosuppressed patients, even in absence of clinical and biochemical signs of hepatitis.

Is Clozapine Useful in Schizophrenic Patients with Concomitant Chronic Inflammatory Disease?

“…hepatitis C as has been reported recently [7]. This suggestion was supported by the results of a bone marrow biopsy in our patient during one episode of neutropenia, which showed no signs of compromised early myeloid precursor cells, which have been reported as the site of toxicity in clozapine-associated agranulocytosis [8].…”

Prevalence of Cytopenia and Evaluation of Its Clinical Significance in Children with influenza A(H1N1)

“…Apart from viral agents like hepatitis B and C viruses which cause marked cytopenia, there are also viral infections causing severe cytopenia like parvovirus B19 and HIV (17). Leucopenia is known to occur frequently in the course of influenza A infections, but isolated thrombocytopenia, anemia and pancytopenia are rare.…”

Evidence of hemolysis in pigs infected with highly virulent African swine fever virus

“…The next etiological component in the pathology of red blood identified in our laboratory is intravascular hemolysis. It appears in the viremia caused by different viruses: Hepatitis C virus [25], cytomegalovirus [26], by some hemorrhagic fever viruses [27,28]. Causes of hemolysis in viral diseases may be the following factors: Pathological immune response, as a type of acute autoimmune reaction [29], direct or indirect action of the virus on erythrocytes [30], the incidence of precursors of erythropoiesis [31], etc.…”