1. Resolution of acute hepatitis B-associated aplastic anaemia with antiviral therapy
- Author
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Sandra L. Hofmann, Joseph A. Moore, Siayareh Rambally, and Nicholas S. Hendren
- Subjects
Adult ,medicine.medical_specialty ,Hypocellular Bone Marrow ,Context (language use) ,Antiviral Agents ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Rare Disease ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Tenofovir ,business.industry ,Anemia, Aplastic ,General Medicine ,Petechial rash ,Hepatitis B ,medicine.disease ,Pancytopenia ,Treatment Outcome ,medicine.anatomical_structure ,Dysplasia ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Bone marrow ,business ,Rare disease - Abstract
A previously healthy 44-year-old woman presented with 3 days of worsening petechial rash, epistaxis and fatigue. Admission labs revealed pancytopenia, low reticulocyte index and elevated liver enzymes. Bone marrow biopsy demonstrated a profoundly hypocellular bone marrow without dysplasia and additional testing demonstrated an acute hepatitis B infection. In the context of an acute hepatitis B infection, elevated liver enzymes and aplastic anaemia, our patient was diagnosed with severe hepatitis-associated aplastic anaemia due to an acute hepatitis B infection. She was initiated on antiviral therapy with tenofovir and briefly received immunosuppressive therapy with a robust sustained improvement in her blood counts. Acute hepatitis B-associated aplastic anaemia is an exceptionally rare presentation of aplastic anaemia. We present acute hepatitis B-associated aplastic anaemia that resolved with antiviral therapy, which to our knowledge is the second such case reported in the literature and the first using tenofovir.
- Published
- 2017