Clinical features of five children with hepatitis-associated aplastic anaemia
10.3760/cma.j.issn.1673-4912.2022.12.012
- VernacularTitle:儿童肝炎相关再生障碍性贫血五例临床特点
- Author:
Meijuan WANG
1
;
Xuemei ZHONG
;
Xin MA
;
Huijuan NING
;
Dan ZHU
;
Youzhe GONG
;
Rong LIU
Author Information
1. 首都儿科研究所附属儿童医院消化内科，北京 100020
- Keywords:
Hepatitis;
Aplastic anaemia;
Clinical characteristics;
Children
- From:
Chinese Pediatric Emergency Medicine
2022;29(12):994-997
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics of hepatitis-associated aplastic anaemia(HAAA)in children.Methods:A retrospective analysis was performed on the clinical manifestations, laboratory examinations, treatments and other clinical data of five children with aplastic anemia(AA)diagnosed by bone marrow examination after admission with acute liver dysfunction admitted to the Department of Gastroenterology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2016 to December 2020.Results:All five children were boys and the onset age of these children ranged from 2 to 13 years.All of the five cases were acute onset and presented with jaundice.The time frame of the diagnosis of HAAA was 0 to 12 weeks from the presentation of the liver disease.One patient had simultaneous onset of hepatitis and aplastic anemia.The liver function was significantly improved at the diagnosis of HAAA in three patients and worsen in one patient.Only one patient showed CMV-DNA positive and the pathogen results of other patients were negative.Lymphocyte immunity disorders were found in all five patients, and the proportion of inhibitory/cytotoxic T lymphocytes(CD3 + CD8 + ) increased.Two children received hematopoietic stem cell transplantation, of which one died and one improved after transplantation.One child improved after treated with antithymocyteglobulin and cyclosporin.One child died due to severe infection.There was no significant improvement in one child treated with cyclosporine. Conclusion:HAAA should be alerted in acute hepatitis patients.Blood routine should be monitored even if liver function improves.Bone marrow tests are needed if patients have peripheral cytopenia in two or more lineages.Early and timely treatments with immunosuppressive therapy and hematopoietic stem cell transplantation can improve the prognosis.
