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Hepatitis-associated aplastic anemia during a primary infection of genotype 1a torque teno virus

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Abstract

A 12-year-old Japanese boy suffered from severe acute hepatitis and pancytopenia. The patient underwent successful bone marrow transplantation from an HLA-identical sister. Torque teno virus (TTV) DNA of genotype 1a and IgM-class antibody against the virus were detected in sera at the onset of hepatitis. TTV/1a DNA and anti-TTV/1a IgM antibody levels were undetectable on the 16th and 46th days after the onset of illness, respectively. Anti-TTV/1a IgG antibody was positive throughout the observation period. Sequential viral load and anti-TTV/1a IgM antibody suggested a primary infection of TTV/1a. Genomic sequence of the virus coincided with that of the original strain first isolated from human. TTV DNA was quantified at 130 copies in 105 bone marrow mononuclear cells, which suggested that infection of hematopoietic cells might be the cause of aplasia. This is the first report of TTV hepatitis-associated aplastic anemia assessed by the anti-TTV antibodies and viral load in peripheral blood and bone marrow.

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Fig. 1
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Abbreviations

AA:

Aplastic anemia

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

BM:

Bone marrow

BMT:

Bone marrow transplantation

EBV:

Epstein–Barr virus

HAA:

Hepatitis-associated aplastic anemia

MNC:

Mononuclear cells

PCR:

Polymerase chain reaction

PB:

Peripheral blood

rr:

Reference range

SAA:

Severe aplastic anemia

TTV:

Torque teno virus

TB:

Total bilirubin

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Acknowledgments

We thank Drs. Takahashi S and Suga N (Div. Pediatr., Beppu Nat. Hosp. Med. Cent., Oita, Japan) for collecting samples and Dr. Nomura A (Dept. Pediatr., Grad. Sch. Med. Sci., Kyushu Univ., Fukuoka, Japan) for the clinical support.

Financial support

This work was supported in part by a Grant-in-Aid for Scientific Research (C) to Ohga S from the Ministry of Education, Culture, Sports, Science, and Technology of Japan.

Potential conflicts of interest

All authors have no conflicts of interest.

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Authors and Affiliations

  1. Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Masataka Ishimura, Shouichi Ohga, Masako Ichiyama, Koichi Kusuhara, Hidetoshi Takada & Toshiro Hara

  2. Division of Virology, Department of Infection and Immunity, School of Medicine, Jichi Medical University, Tochigi, Shimotsuke, Japan

    Masaharu Takahashi & Hiroaki Okamoto

Authors
  1. Masataka Ishimura
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  2. Shouichi Ohga
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  3. Masako Ichiyama
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  4. Koichi Kusuhara
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  5. Hidetoshi Takada
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  6. Toshiro Hara
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  7. Masaharu Takahashi
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  8. Hiroaki Okamoto
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Corresponding author

Correspondence to Shouichi Ohga.

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Ishimura, M., Ohga, S., Ichiyama, M. et al. Hepatitis-associated aplastic anemia during a primary infection of genotype 1a torque teno virus. Eur J Pediatr 169, 899–902 (2010). https://doi.org/10.1007/s00431-009-1116-8

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  • DOI: https://doi.org/10.1007/s00431-009-1116-8

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