Long-term follow-up of hepatitis-associated aplastic anaemia

Prognosis of hepatitis-associated aplastic anaemia (HAAA) was improved with haematopoietic stem cell transplantation (HSCT) and immunosuppression, but the long-term outcome remains undefined. Case 1: a girl aged 3 years with acute liver failure (ALF) submitted to orthotopic liver transplantation (OL...

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Bibliographic Details
Published in:BMJ case reports 2017-12, Vol.2017, p.bcr-2017-221434
Main Authors: Gonçalves, Cristina, Ferreira, Sandra, Nobre, Susana, Gonçalves, Isabel
Format: Article
Language:English
Subjects:
Acyclovir - administration & dosage
Acyclovir - therapeutic use
Anemia
Anemia, Aplastic - complications
Anemia, Aplastic - diagnosis
Anemia, Aplastic - drug therapy
Antiviral Agents - administration & dosage
Antiviral Agents - therapeutic use
Biopsy
Blood
Blood platelets
Bone marrow
Case reports
Child
Child, Preschool
Diagnosis, Differential
Female
Follow-Up Studies
Hematology
Hematopoietic Stem Cell Transplantation
Hepatitis
Hepatitis - complications
Hepatitis - diagnosis
Hepatitis - drug therapy
Humans
Immunotherapy
Liver
Liver Failure, Acute
Liver Transplantation
Monoclonal antibodies
Neutrophils
Patients
Postoperative Complications - diagnosis
Stem cell transplantation
Transplants & implants
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
Citations: Items that this one cites
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Summary:Prognosis of hepatitis-associated aplastic anaemia (HAAA) was improved with haematopoietic stem cell transplantation (HSCT) and immunosuppression, but the long-term outcome remains undefined. Case 1: a girl aged 3 years with acute liver failure (ALF) submitted to orthotopic liver transplantation (OLT) subsequently developed aplastic anaemia and HSCT from a compatible sibling was performed. Post-HSCT, the patient developed post-transplant lymphoproliferative disorder and rituximab was administered with good response. Fifteen years later, both grafts show good outcome. Case 2: a girl aged 10 years submitted to OLT due to ALF, developed pancytopenia 2 months later. Due to the absence of a human leucocyte antigen compatible donor, she was treated with ciclosporin and antithymocyte globulin with very good long-term outcome. These clinical cases suggest that, for patients with HAAA that underwent OLT, aggressive therapy with HSCT or immunosuppression may provide a benign long-term outcome.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-221434