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Báo cáo y học: "Aplastic anemia associated with interferon alpha 2a in a patient with chronic hepatitis C virus infection: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Aplastic anemia associated with interferon alpha 2a in a patient with chronic hepatitis C virus infection: a case report. | loannou et al. Journal of Medical Case Reports 2010 4 268 http www.jmedicalcasereports.eom content 4 1 268 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Aplastic anemia associated with interferon alpha 2a in a patient with chronic hepatitis C virus infection a case report Savvas loannou Gregorios Hatzis Ioanna Vlahadami Michael Voulgarelis Abstract Introduction Hepatitis-associated aplastic anemia is a common syndrome in patients with bone marrow failure. However hepatitis-associated aplastic anemia is an immune-mediated disease that does not appear to be caused by any of the known hepatitis viruses including hepatitis C virus. In addition to the best of our knowledge there are no reported cases of patients with chronic hepatitis C virus infection developing aplastic anemia associated with pegylated interferon alpha 2a treatment. Case presentation We report the case of a 46-year-old Greek man who developed severe aplastic anemia during treatment with pegylated interferon alpha 2a for chronic hepatitis C virus infection. He presented with generalized purpura and bruising as well as pallor of the skin and mucous membranes. His blood tests showed pancytopenia. He underwent allogeneic bone marrow transplantation after completing two courses of immunosuppressive therapy with antithymocyte globulin and cyclosporin A. Conclusions The combination of a specific environmental precipitant represented by the hepatitis C virus infection an altered metabolic detoxification pathway due to treatment with pegylated interferon alpha 2a and a facilitating genetic background such as polymorphism in metabolic detoxification pathways and specific human leukocyte antigen genes possibly conspired synergistically in the development of aplastic anemia in this patient. Our case clearly shows that the causative role of pegylated interferon alpha 2a in the development of aplastic anemia must not be ignored. Introduction Hepatitis C virus HCV infection is a major public health