Skip to main content
SpringerLink
Log in

Severe aplastic anemia associated with seronegative community-acquired hepatitis C virus infection

  • Case Report
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Summary

Aplastic anemia (AA) is a rare complication of viral hepatitis affecting mainly children or young adults. Most reported cases have been associated with community-acquired non-A, non-B hepatitis, but hepatitis A and B have also been implicated in a few patients. We report on a 43-year-old woman with severe AA, in association with acute hepatitis C virus (HCV) infection, diagnosed by detection of HCV RNA by the polymerase chain reaction technique. Her AA was successfully treated with anti-thymocyte globulin and cyclosporin A. The hepatitis C progressed to chronic disease but, despite a follow-up time of 2 years, the patient still has no detectable anti-HCV antibodies, as evaluated with a secondgeneration anti-HCV assay.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aoyagi K, Ohhara N, Okamura S, Otsuka T, Shibuya T, Yamano Y, Tsuda Y, Niho Y (1987) Aplastic anemia associated with type-A viral hepatitis. Jpn J Med 26: 348–352

    PubMed  Google Scholar 

  2. Bannister P, Miloszewski K, Barnard D, Losowsky MS (1983) Fatal marrow aplasia associated with non-A, non-B hepatitis. Br Med J 286: 1314–1315

    Google Scholar 

  3. Björkholm M (1992) Aplastic anemia: pathogenetic mechanisms and treatment with special reference to immunomodulation. J Intern Med 231: 575–582

    PubMed  Google Scholar 

  4. Böttiger LE, Westerholm B (1972) Aplastic anemia. III. Aplastic anemia and infectious hepatitis. Acta Med Scand 192: 323–326

    PubMed  Google Scholar 

  5. Cargnel A, Vigano P, Davoli C, Morelli R, Perna MC, Mariscotti C (1983) Sporadic acute non-A non-B hepatitis complicated by aplastic anemia. Am J Gastroenterol 78: 245–247

    PubMed  Google Scholar 

  6. Chong RSE, Ng HS, Ong YY, Tan HC (1990) A case of aplastic anemia associated with fulminant hepatitis B. Singapore Med J 31: 75–77

    PubMed  Google Scholar 

  7. Dhingra K, Michels SD, Winton EF, Gordon DS (1988) Transient bone marrow aplasia associated with non-A, non-B hepatitis. Am J Hematol 29: 168–171

    PubMed  Google Scholar 

  8. Doménech P, Palomeque A, Martínez-Gutiérrez A, Viñolas N, Vela E, Jiménez R (1986) Severe aplastic anemia following hepatitis A. Acta Haematol 76: 227–229

    PubMed  Google Scholar 

  9. Foon KA, Mitsuyasu RT, Schroff RW, McIntyre RE, Champlin R, Gale RP (1984) Immunologic defects in young male patients with hepatitis-associated aplastic anemia. Ann Intern Med 100: 657–662

    PubMed  Google Scholar 

  10. Garson JA, Tuke PW, Makris M, Briggs M, Machin SJ, Preston FE, Tedder RS (1990) Demonstration of viraemia patterns in haemophiliacs treated with hepatitis-C-virus-contaminated factor VIII concentrates. Lancet 336: 1022–1025

    PubMed  Google Scholar 

  11. Gordon-Smith EC (1989) Aplastic anaemia-aetiology and clinical features. Baillieres Clin Haematol 2: 1–18

    Google Scholar 

  12. Hagler L, Pastore RA, Bergin JJ (1975) Aplastic anemia following viral hepatitis: report of two fatal cases and a literature review. Medicine 54: 139–164

    PubMed  Google Scholar 

  13. Kurtzman G, Young N (1989) Viruses and bone marrow failure. Baillieres Clin Haematol 2: 51–67

    PubMed  Google Scholar 

  14. Liang DC, Lin KH, Lin DT, Yang CP, Hung KL, Lin KS (1990) Post-hepatic aplastic anaemia in children in Taiwan, a hepatitis prevalent area. Br J Haematol 74: 487–491

    PubMed  Google Scholar 

  15. Lorenz F, Quasier K (1955) Panmyelopathie nach Hepatitis epidemica. Wien Med Wochenschr 105: 19–22

    PubMed  Google Scholar 

  16. McSweeney PA, Carter JM, Green GJ, Romeril KR (1988) Fatal aplastic anemia associated with hepatitis-B viral infection. Am J Med 85: 255–256

    PubMed  Google Scholar 

  17. Pol S, Driss F, Devergie A, Brechot C, Berthelot P, Gluckman E (1990) Is hepatitis-C virus involved in hepatitis-associated aplastic anemia? Ann Intern Med 113: 435–437

    PubMed  Google Scholar 

  18. Qi Z, Yi-nan Z, Wen-jie L (1990) Sporadic acute non-A, non-B hepatitis complicated by aplastic anemia and haemolysis. Chin Med J 103: 959–960

    PubMed  Google Scholar 

  19. Sandberg T, Lindquist O, Norkrans G (1984) Fatal aplastic anemia associated with non-A, non-B hepatitis. Scand J Infect Dis 16: 403–404

    PubMed  Google Scholar 

  20. Shannon K, Koehne W, Heyman MB, Koerper MA (1990) Relapsing post-hepatitis aplastic anemia. Clin Pediatr 29: 25–29

    Google Scholar 

  21. Smith D, Gribble TJ, Yeager AS, Greenberg HB, Purcell RH, Robinson W, Schwartz HC (1978) Spontaneous resolution of severe aplastic anemia associated with viral hepatitis A in a 6-year-old child. Am J Hematol 5: 247–252

    PubMed  Google Scholar 

  22. Tzakis AG, Arditi M, Whitington PF, Yanaga K, Esquivel C, Andrews WA, Makowka L, Malatak J, Freese DK, Stock PG, Ascher NL, Johnson FL, Broelsch CE, Starzi TE (1988) Aplastic anemia complicating orthotopic liver transplantation for non-A, non-B hepatitis. N Engl J Med 319: 393–396

    PubMed  Google Scholar 

  23. Widell A, Mansson AS, Sundström G, Hansson BG, Nordenfelt E (1991) Hepatitis-C virus RNA in blood donor sera detected by the polymerase chain reaction: comparison with supplementary hepatitis-C antibody assays. J Med Virol 35: 253–258

    PubMed  Google Scholar 

  24. Young NS (1990) Flaviviruses and bone marrow failure. JAMA 263: 3065–3068

    PubMed  Google Scholar 

  25. Zeldis JB, Dienstag JL, Gale RP (1983) Aplastic anemia and non-A, non-B hepatitis. Am J Med 74: 64–68

    Google Scholar 

  26. Zeldis JB, Boender PJ, Hellings JA, Steinberg H (1989) Inhibition of human hemopoiesis by non-A, non-B hepatitis virus. J Med Virol 27: 34–38

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Medicine, Section of Hematology and Immunology, Karolinska Hospital, S-10401, Stockholm, Sweden

    A. Gruber & M. Björkholm

  2. Department of Clinical Microbiology, Section of Virology, Karolinska Hospital, Sweden

    L. Grillner

  3. National Bacteriological Laboratory, Stockholm, Sweden

    H. Norder & L. Magnius

Authors
  1. A. Gruber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Grillner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Norder
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. L. Magnius
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. Björkholm
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gruber, A., Grillner, L., Norder, H. et al. Severe aplastic anemia associated with seronegative community-acquired hepatitis C virus infection. Ann Hematol 66, 157–159 (1993). https://doi.org/10.1007/BF01697628

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01697628

Key words

Search

Navigation