The Syndrome of Hepatitis and Aplastic Anaemia

Abstract

Summary. Eighty‐eight cases of severe pancytopcnia closely following the onset of apparently typical viral hepatitis have been described. We report two additional patients. Remarkable features of the syndrome are the rapid, high mortality (88%) and the fact that the age and sex distribution parallel that of hepatitis, not that of other wries of aplastic anaemia. Although viral damage to haematopoietic cells can be demonstrated in vitro, chromosonies in our patients were normal after short‐term culture of peripheral lyrnpliocytes. Therapeutically, androgens may be of some benefit despite the high mortality. No adequate explanation for the association is available, but infectious hepatitis should be accepted as a potential cause of aplastic anacmia.

Lack of known hepatitis virus in hepatitis-associated aplastic anemia and outcome after bone marrow transplantation

“…63 The prognosis of patients with HAAA has been reported to be extremely poor. 15,16,64 Previous publications have suggested that HAAA of the same degree of severity responds as well as does that with no prior history of hepatitis to treatment with both immunosuppression and with BMT. 24,[65][66][67][68][69][70] Children appear to respond better to BMT than do adults with HAAA.…”

“…[11][12][13] The relationship between hepatitis and the subsequent development of AA has been documented in over 200 cases. 11,[14][15][16] Although HAV and HBV have been associated with AA in a small number of patients, most cases are related to non-A, non-B viral hepatitis. 17,18 The median survival of untreated patients with AA is 3 to 6 months, with only 20% surviving beyond 1 year.…”

Acquired Aplastic Anaemia in Adults

“…A u o u n i and D o e b l in [1] reviewed 88 cases and found a mortality of more than 88%> 10 months after diagnosis. The hepatitis-aplastic anaemia syndrome shows the age and sex patterns of viral hepatitis, i.e., it occurs mainly in male patients below the age of 30.…”

Viral Hepatitis B and Aplastic Anemia

“…When viral hepatitis was considered, acute viral hepatitis A was suggested since HBSAg was negative in the patients tested (Ajlouni and Doeblin 1974). However, HBSAg was so far examined in only a small number of reported cases (Toda 1973 …”

“…Although some of them belong to the chloramphenicol-hepatitis-aplastic anemia syndrome (Hodgkinson 1973), most of them are believed to have had acute viral hepatitis (Ajlouni and Doeblin 1974;Camitta et al 1974). In spite of recent advances in detecting hepatitis B surface antigen (HBSAg), however, no HBS-Ag-positive case has been reported.…”