Spectrum of bone marrow morphologic findings in hepatitis C patients with and without prior liver transplantation

Boone, Jamie; Cui, Wei

doi:10.1111/ijlh.12559

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…The prevalence of bone marrow abnormalities that may be the underlying pathology is largely understudied. Several authors had studied the bone marrow findings in patients with hepatitis C 10–12. Anwar et al 13 studied the utility of bone marrow examination in patients with CLD and found this test to be quite useful especially in patients with severe pancytopaenia and those with sudden alterations in peripheral cell counts.…”

Section: Discussionmentioning

confidence: 99%

Bone marrow dyspoiesis associated with severe refractory anaemia in liver cirrhosis

Varadarajan

Lal

Kapil

et al. 2020

Frontline Gastroenterol

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Background and aimPeripheral cytopaenias and dyspoiesis are common in cirrhosis; however, the prevalence of dyspoiesis and its contribution in cirrhosis-related cytopaenias has not been studied. We aimed to study the bone marrow (BM) dyspoiesis and its impact on peripheral blood cell counts and refractory anaemia in patients with cirrhosis.Patients and methodsWe reviewed all the BM aspirates and biopsies of cirrhotic cases, done from 2011 to 2018 for clinical indications. Dyspoiesis was considered if >5% of the precursor cells of any of the three lineages showed dyspoietic changes. Primary haematological or non-haematological malignancies, chronic kidney disease, drug intake, acute and chronic hepatitis and granulomatous disease were excluded.ResultsOf 608 these, 82 cases (13.5%) showed dyspoiesis in the BM precursors. There was no difference in age (p=0.16), gender (p=0.58) and spleen size (p=0.35) in cases with or without dyspoiesis. Majority of the cases had dyspoiesis in erythroid series (62, 75.6%) and megakaryocytes (15, 18.2%). Dyspoiesis was more prominent in alcoholics 44 cases (53.6%) and autoimmune diseases 13 cases (15.8%). Erythroid hyperplasia (47.7±14.4 vs 40±11.1; p<0.001) was more in cases with dyserythropoiesis, indicating ineffective erythropoiesis. Patients with dyspoiesis had lower haemoglobin (7.5±1.9 vs 9.3±2.2 g/dL, p<0.001). 54 (8.07%) had refractory anaemia with dyspoiesis present in 48 (88.8%) (p<0.01). Dyspoiesis was independently associated with refractory anaemia when adjusted for age, gender, aetiology and liver disease severity.ConclusionsBM dyspoiesis, especially dyserythropoiesis, is associated with severe refractory anaemia in patients with cirrhosis and requires new therapeutic approaches.

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Section: Discussionmentioning

confidence: 99%

Bone marrow dyspoiesis associated with severe refractory anaemia in liver cirrhosis

Varadarajan

Lal

Kapil

et al. 2020

Frontline Gastroenterol

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“…Previously, Das et al reported a 10-year-old girl infected with HAV that developed pancytopenia (3). In addition to HAV, hepatitis due to other viruses, including hepatitis G (HGV) and HCV has also been described along with pancytopenia (9,10). Despite that this is unusual, it is advisable to consider bone marrow failure in the patients infected with hepatitis and present with a decreased count of all blood cell lineages.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis A Infection Presented with Pancytopenia, a Case Series in Children

et al. 2019

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Introduction: Extrahepatic presentation in hepatitis is a relatively uncommon clinical condition. In particular, pancytopenia related to hepatitis is a rare phenomenon encountered in these patients. Pancytopenia can be associated with a variety of hepatitis viruses; however, its association with hepatitis A virus (HAV) is unusual. Case Presentation: In current case series, we reported 11 children who presented with three suppressed blood lineages, including white blood cells, platelets, reticulocytes, and hemoglobin with mean values of 2.4 × 103/µL, 54.5 × 103/µL, 1%, and 9.4 g/dL. Of these 11 children, 5 were boys. The mean age was 6.5 years old. The patients presented with abdominal pain, hepatitis, and pallor. Biochemical analysis showed liver function enzymes were increased in all patients. Serologic studies for antibodies against viral components, including hepatitis B (HBV), hepatitis C (HCV), and HAV, as well as cytomegalovirus (CMV) showed positive results for anti-HAV IgM. Coombs tests were negative in all the patients. Conclusions: Clinicians should consider extrahepatic presentations of hepatitis infections, especially HAV infection that may present with non-specific clinical features. This can help health care providers to timely and correct diagnosis and treatment of this infection.

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Spectrum of bone marrow morphologic findings in hepatitis C patients with and without prior liver transplantation

Cited by 2 publications

References 22 publications

Bone marrow dyspoiesis associated with severe refractory anaemia in liver cirrhosis

Bone marrow dyspoiesis associated with severe refractory anaemia in liver cirrhosis

Hepatitis A Infection Presented with Pancytopenia, a Case Series in Children

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