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[Hepatitis-associated aplastic anemia preceded by a hemophagocytic syndrome-like state]
- Source :
- [Rinsho ketsueki] The Japanese journal of clinical hematology. 44(10)
- Publication Year :
- 2003
-
Abstract
- A 21-year-old man was admitted to our hospital for acute hepatitis of unknown cause. His liver function improved with rest, but worsened 2 months later. He developed a high fever and pancytopenia. The serum level of cytokines including TNF-alpha, IFN-gamma, IL-6, and M-CSF was elevated, and hemophagocytes were seen in bone marrow. These findings suggested a hemophagocytic syndrome-like state. With prednisolone, gamma-globulin, and G-CSF, the high fever disappeared and the patient's liver function gradually recovered. However, the severe pancytopenia persisted. The bone marrow became acellular with a small number of hemophagocytes, and hepatitis-associated aplastic anemia was diagnosed. After immunosuppressive therapy with ATG, CyA and G-CSF was started, and the patient showed hematopoietic reconstitution. The bone marrow CD4+/CD8+ lymphocyte ratio recovered to within the normal range, and the serum cytokines including TNF-alpha and IFN-gamma decreased. The increase in serum cytokines, particularly TNF-alpha and INF-gamma, as well as the presence of activated T cells associated with the preceding hemophagocytic syndrome-like state may have predisposed this patient to aplastic anemia.
Details
- ISSN :
- 04851439
- Volume :
- 44
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- [Rinsho ketsueki] The Japanese journal of clinical hematology
- Accession number :
- edsair.pmid..........d8c534097b5c78f4b3f74fe6bb0bd34a