Pure Red Cell Aplasia Associated With Hepatitis C Infection

Al-Awami, Yusra; Sears, David; Carrum, George; Udden, Mark M.; Alter, Blanche P.; Conlon, Charles L.

doi:10.1016/s0002-9629(15)40177-6

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…The result is a transient period of asymptomatic aplasia in the majority of infected individuals, but immunosuppressed patients and those with chronic hemolytic anemia may develop life-threatening aplastic crises [18]. Various other infections including HCV, hepatitis A and B, HIV, CMV, and disseminated tuberculosis have been associated with development of PRCA [19][20][21][22][23][24][25]. Successful treatment of HCV has been associated with sustained hematologic remission of PRCA [20].…”

Section: Discussionmentioning

confidence: 99%

Pure red cell aplasia caused by ribavirin and interferon treatment

Skabelund

Hauser

Goist

2011

Clin J Gastroenterol

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Anemia is a common complication of hepatitis C (HCV), and antiviral treatment can further increase this risk. We present the case of a 59-year-old man with HCV treated with ribavirin and pegylated interferon alpha (INF-α) who presented with severe anemia. Two months after initiating treatment his hemoglobin dropped from 14.2 to 5.0 g/dL. There was no evidence of bleeding or hemolysis, and a bone marrow biopsy revealed pure red cell aplasia (PRCA). Evaluations for acute cytomegalovirus and parvovirus B19 were negative. There was no evidence of malignancy or thymoma. The INF-α and ribavirin treatment were determined to have caused the PRCA, and withdrawal of the medications led to PRCA remission. INF-α and ribavirin have become the standard treatment for HCV. While these medications offer a potential cure, they are often poorly tolerated due to frequent side effects including anemia. Patients who are receiving treatment with ribavirin and INF-α warrant close monitoring for development of anemia, and PRCA should be considered in all patients in whom reticulocytopenic anemia develops.

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Section: Discussionmentioning

confidence: 99%

Pure red cell aplasia caused by ribavirin and interferon treatment

Skabelund

Hauser

Goist

2011

Clin J Gastroenterol

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“…Multiple pathological mechanisms of druginduced PRCA have been suggested, including direct toxic effects on DNA synthesis by erythroid cells and indirect effects on accessory cells required for erythroid progenitor cells to differentiate into mature erythroblasts (59,60). Reports of HBV-related PRCA (11,52,61,62) suggest possible mechanisms, such as direct viral effects on hematopoietic cells, production of toxic substances by injured hepatocytes, an inability to inactivate erythropoietic toxins due to an impaired liver function, and autoimmune suppression of red blood cell production. However, the precise mechanism remains unknown.…”

Section: Prca and Hbv Infectionmentioning

confidence: 99%

Hemolytic Anemia after Acute Hepatitis B Virus Infection: A Case Report and Systematic Review

et al. 2022

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Hemolytic anemia and pure red cell aplasia are rare hematological complications of hepatitis B virus infection. We herein report a 24-year-old man who was diagnosed with hemolytic anemia and possible transient pure red cell anemia eight weeks after a severe episode of acute hepatitis B virus infection. Rapid recovery was observed with conservative management. Hemoglobin returned to baseline within three months. As the clinical features of hemolytic anemia associated with hepatitis B virus have not yet been elucidated, we conducted a systematic review and present an analysis of the 20 reported cases, including our present case.

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“…1 Although PRCA is a rare phenomenon, it has been wellcharacterized in relation to certain specific inciting causes. These include the most rarely reported, resulting from an acute viral infection such as hepatitis C, 2,3 or more frequently reported, exposure to parvovirus B19, in which the parvovirus directly attacks the pro-erythroblasts. [4][5][6] Other frequent occurrences are related to autoimmune disorders, which produce erythroid destruction related to both antibodies (lymphoproliferative disorders, systemic lupus erythematosus, rheumatoid arthritis) 7,8 and to T-cell dysfunction (thymoma).…”

Section: Introductionmentioning

confidence: 99%

Pure Red Cell Aplasia Following Interleukin-2 Therapy

Dutcher

Fan

Wiernik

2016

Journal of Investigative Medicine High Impact Case Reports

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A 61-year-old woman with metastatic renal cell carcinoma underwent systemic treatment with high-dose interleukin-2 (IL-2). Anemia requiring transfusion of 1 unit of packed red blood cells (PRBCs) was required during the second week of IL-2 therapy. One month following completion of high-dose IL-2 treatment, she was hospitalized for severe, symptomatic anemia and received 5 units of PRBCs. She was referred back for evaluation. A complete hematologic evaluation was performed including antiviral serology, evaluation for hemolysis, complete iron studies, and finally bone marrow aspiration and biopsy. The diagnosis was pure red cell aplasia, and no inciting viral cause could be ascertained. She required PRBCs for 5 months following IL-2 therapy. It was concluded that IL-2 was the cause of her red cell aplasia. This subsequently resolved spontaneously, and she had normal hemoglobin and hematocrit, respectively, 1 and 2 years after treatment.

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Pure Red Cell Aplasia Associated With Hepatitis C Infection

Cited by 8 publications

References 37 publications

Pure red cell aplasia caused by ribavirin and interferon treatment

Pure red cell aplasia caused by ribavirin and interferon treatment

Hemolytic Anemia after Acute Hepatitis B Virus Infection: A Case Report and Systematic Review

Pure Red Cell Aplasia Following Interleukin-2 Therapy

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