Severe Aplastic Anemia following Parvovirus B19-Associated Acute Hepatitis

Furukawa, Masanori; Kaji, Kosuke; Masuda, Hiroyuki; Ozaki, Kuniaki; Asada, Shohei; Koizumi, Aritoshi; Kubo, Takuya; Nishimura, Norihisa; Sawada, Yasuhiko; Takeda, Kosuke; Mashitani, Tsuyoshi; Kubo, Masayuki; Amano, Itsuto; Ootani, Tomoyuki; Ohbayashi, Chiho; Murata, Koji; Ann, Tatsuichi; Mitoro, Akira; Yoshiji, Hitoshi

doi:10.1155/2017/1359486

Cited by 10 publications

(5 citation statements)

References 33 publications

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“…If none of the above-mentioned tests are positive, possibility of other infective agents should not be forgotten—CMV [ 37 ], malaria [ 38 ], parvovirus b19 [ 39 ], influenza [ 40 ], rubella [ 41 ], hepatitis A [ 42 ], adenovirus [ 43 ], schistosomiasis [ 44 ], histoplasmosis [ 45 ], MAV [ 34 ], typhoid fever [ 47 ]—and the samples should be tested against these microorganisms.…”

Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Chakhunashvili,

Kvirkvelia

2024

J Med Case Reports

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Background Visceral Leishmaniasis should be suspected in every patient with a history of splenomegaly, fever, and pancytopenia. It is one of the most dangerous forms of infection and prompt recognition is the key to positive outcome. Case presentation A 20-month-old Caucasian male patient was brought to our hospital as an outpatient with the complaint of persistent fever, which did not improve with empiric antibiotic treatment (> 96 hour after the initial dose). The antibiotic treatment had been prescribed by primary care physician at polyclinic, who also referred the patient to hematologist due to anemia, who prescribed iron supplement. Despite multiple subspecialist visits, bicytopenia was, unfortunately, left unidentified. Upon physical examination no specific signs were detected, however, spleen seemed slightly enlarged. Patient was admitted to the hospital for further work-up, management and evaluation. Abdominal ultrasound, complete blood count and c-reactive protein had been ordered. Hematologist and infectionist were involved, both advised to run serology for Epstein-Barr Virus and Visceral Leishmaniasis. The latter was positive; therefore, patient was transferred to the specialized clinic for specific management. Conclusion Both in endemic and non-endemic areas the awareness about VL should be increased among the medical professionals. We also recommend that our colleagues take the same approach when dealing with bicytopenia and fever, just as with pancytopenia and fever. The medical community should make sure that none of the cases of fever and pancytopenia are overlooked, especially if we have hepatomegaly and/or splenomegaly.

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Section: Discussionmentioning

confidence: 99%

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Chakhunashvili,

Kvirkvelia

2024

J Med Case Reports

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“…By promoting direct lysis of bone marrow progenitor cells, parvovirus B19 can cause aplastic crises. Parvovirus B19 is a documented aetiological factor for AA, particularly in individuals with a history of haemolytic anaemia (9) . However, parvovirus B19 infection was excluded in the present patient.…”

Section: Discussionmentioning

confidence: 99%

Clinical heterogeneity of an autoimmune disease: a case of concomitant autoimmune anaemia, autoimmune hepatitis and autoimmune bone marrow aplasia

Zatońska¹,

Rogowska²,

Król³

et al. 2019

Pediatr Med Rodz

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In autoimmune diseases, the host's immune system produces antibodies against antigens naturally occurring in its body. The immune response can be triggered by both own and foreign antigens. An important role in controlling an autoimmune process is played by genetic and environmental factors, including infections which may cause autoantibody production. The pathogenesis of autoimmune haemolytic anaemia, autoimmune hepatitis and aplastic anaemia involves autoaggressive processes. The case described in the present paper involves the coexistence of those three diseases in one patient. It is worth noting that they occur one after the other: once one of them goes into remission, another one starts manifesting itself. This study aims to draw attention to the possibility of coexistence of different autoaggressive diseases, the presence of significant correlations between them and the need to maintain vigilance with respect to patients in remission of an autoimmune disease.

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“…With documented 10 consecutive weeks of parvovirus B19-negative blood PCR results during the period of acute hepatitis, parvovirus B19 infection must have been a consequence and not the cause of pancytopenia. Rare cases of pancytopenia due to parvovirus B19 have been described [21], especially in immunocompromised patients [22]. Mostly, these will resolve spontaneously.…”

Section: Discussionmentioning

confidence: 99%

Acute hepatitis as a prequel to very severe aplastic anemia

et al. 2018

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Severe aplastic anemia is a rare and potentially life-threatening disease of the bone marrow often requiring allogeneic hematopoietic stem cell transplantation. Pathogenesis of the disease can vary and often remains enigmatic. Occasionally, severe aplastic anemia is associated with prior severe acute hepatitis. Differential diagnosis of acute non-viral hepatitis challenges the physician as pathogenesis remains unclear.We here present a case of a young patient presenting with acute hepatitis followed by severe aplastic anemia successfully treated with allogeneic hematopoietic stem cell transplantation. Due to immunosuppressive treatment with azathioprine for acute hepatitis of putative autoimmune pathogenesis and coincident infection with parvovirus B19, diagnosis of the sequential disease of acute hepatitis followed by severe aplastic anemia was complicated. We discuss the caveats and present a review of the literature.

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Severe Aplastic Anemia following Parvovirus B19-Associated Acute Hepatitis

Cited by 10 publications

References 33 publications

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Visceral leishmaniasis misdiagnosed as an upper respiratory infection and iron-deficiency anemia in a 20-month-old male patient: a case report

Clinical heterogeneity of an autoimmune disease: a case of concomitant autoimmune anaemia, autoimmune hepatitis and autoimmune bone marrow aplasia

Acute hepatitis as a prequel to very severe aplastic anemia

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