Clinical research of childhood hepatitis-associated aplastic anemia
10.3760/cma.j.issn.1673-4912.2015.09.003
- VernacularTitle:儿童肝炎相关性再生障碍性贫血临床特征研究
- Author:
Ying CHEN
;
Nan LIN
;
Mei SUN
- Publication Type:Journal Article
- Keywords:
Hepatitis;
Aplastic anemia;
Children;
Clinical characteristics
- From:
Chinese Pediatric Emergency Medicine
2015;22(9):603-606
- CountryChina
- Language:Chinese
-
Abstract:
Objective Hepatitis-associated aplastic anemia( HAAA) is a rare and severe disease that can be fatal,if left untreated. In the childhood,it is a syndrome in which marrow failure follows the develop-ment of hepatitis. The aim of this study was to summary clinical characteristic of children with HAAA. Methods We retrospectively reviewed the hospital records of 7 children with HAAA from 2001 to 2010,and summarized and classified the clinical features of HAAA,the laboratory characteristics in 7 patients with com-bined aplastic anemia and severe hepatits,the immune status of those patients,the pathogen of those patients and the results of treatment. Results The average age of patients was 11. 1 years old(8~14 years old). The clinical features were similar in all cases. The early stage of disease,all the children had markedly elevated liver enzyme levels and peripheral blood count was normal. After symptomatic treatment,the hepatic function began to recover but appeared pancytopenia. Bone marrow biopy showed hypoplasia. The median time from onset of hepatic symptoms until diagnosis of aplasic anemia was 43. 3 days. All the children had immune dis-order. Only one boy showed parovirus B19-IgM positive and another girl was diagnosed as acute HAV hepati-tis,the pathogen results of other children were negative. All the patients were treated by immunosuppressive therapy,one patient gave up due to some reasons and others had completed remission. Conclusion HAAA is a life-threatening hematologic disorder in which an episode of hepatitis precedes AA by a period of weeks or months. Characteristically,the HAAA syndrome is more prevalent among young men. It is reported that it is in a higher frequency of patients with non-A,non-B hepatitis. Clincal features and experimental results strong-ly suggest a central role for an immune-mediated pathogenesis. The main treatment is immunosuppressive therapy,which include hormone,antithymocyte glubulin and cyclosporine.
