Flaviviruses and bone marrow failure

Article Abstract:

The case is described of a young man who was an army private stationed in Italy; he developed aplastic anemia following a bout of hepatitis B. Aplastic anemia is characterized by inadequate production of red blood cells due to dysfunction of the bone marrow, where these cells are synthesized. The symptoms and successful treatment of this patient are described, and related issues, such as the etiology of aplastic anemia, are discussed in greater detail. It is suggested that the bone marrow failure underlying aplastic anemia may be caused by an infectious agent, specifically a virus. During many viral infections, the bone marrow production of blood cells is slightly depressed, while other viruses can cause a more severe reaction called an aplastic crisis. The single most common infection found to precede aplastic anemia is hepatitis, an inflammatory infection of the liver. Of the three types of hepatitis, which are A, B, and non-A non-B, the last type most frequently precedes aplastic anemia. The patient described in this report was diagnosed with hepatitis B, but may also have had the non-A non-B form, which tends to be transmitted with hepatitis B. The reason for the name 'non-A non-B' is that there may be several related viruses involved in these cases of hepatitis that are not caused by the A or B viruses. One of the non-A non-B viruses, hepatitis C, appears to be related to viruses in the family known as flaviviruses, which cause disease in humans. The authors hypothesize that aplastic anemia may result from infection with hepatitis C virus or a related virus from the flavivirus family; the possible mechanisms by which this could occur are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Physiological aspects, Diseases, Bone marrow, Hepatitis B, Bone marrow diseases, Hepatitis C virus, Hepatitis E

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Aplastic anemia and viral hepatitis: non-A, non-B, non-C?

Article Abstract:

Hepatitis-associated aplastic anemia (H-AA) hepatitis may not be caused by hepatitis A, hepatitis B or hepatitis C virus. Aplastic anemia is a rare disease that is usually associated with a viral infection, and is often fatal. Of 28 patients with H-AA, 10 (36%) had ribonucleic acid from the hepatitis virus in their blood. Hepatitis C virus was not detected in the bone marrow or blood of three H-AA patients who were tested at the time of diagnosis. The levels of T-lymphocytes, or cells of the immune system, were elevated from three to 20 times their normal level early during the course of infection in these patients. Hepatitis C virus was detected in the blood of 10 patients who received blood transfusions for the treatment of aplastic anemia, but they may have received contaminated blood. Seven of 12 patients (58%) transfused with more than 21 pints of blood were infected with hepatitis C, compared to only three of the 16 patients who received 20 units or less of blood. Hepatitis C virus was not found in liver samples from three patients who developed H-AA after receiving a liver transplant.

Hepatitis, Viral, Viral hepatitis

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Acquired Aplastic Anemia

Article Abstract:

Hepatitis, abnormal liver function, and fatigue in a 27-year-old man illustrate a typical case of aplastic anemia. Aplastic anemia may result from exposure to industrial chemicals, pharmaceutical drugs, or an unknown cause. The bone marrow is replaced by fat tissue, stopping production of blood cells and leading to anemia and a low level of white blood cells and blood platelets. Stem cell transplantation and immunosuppressive therapy, along with blood transfusions, may restore bone marrow function and reverse the anemia.

United States, Care and treatment, Statistical Data Included, Hematopoietic stem cells, Hematopoietic stem cell transplantation

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