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Transient Red Blood Cell Aplasia in Association With Viral Hepatitis: Occurrence Four Years Apart in Siblings

Transient Red Blood Cell Aplasia in Association With Viral Hepatitis: Occurrence Four Years Apart... Abstract Various forms of hematopoietic suppression have been reported in viral hepatitis.1 Moderate neutropenia and lymphocytopenia, followed by relative lymphocytosis with reactive lymphocytes, are common in the early stages of the disease,2 and agranulocytosis has been observed.3 Severe, usually fatal, pancytopenia has been described in conjunction with or following hepatitis in at least 30 cases.4 Transient pure erythroid aplasia was observed in a patient with hepatitis attributed to halothane anesthesia.5 In the two patients whose cases are described herein, transient red blood cell (RBC) aplasia with severe anemia was demonstrated during the course of viral hepatitis. Of particular interest is the fact that the patients are siblings whose illnesses occurred four years apart. PATIENT SUMMARIES Patient1. —A 26-year-old man (Table) was first admitted to the Bexar County Hospital on April 5, 1972, because of pain in his left ankle and knee. He had been in References 1. Sears DA, George JN, Gold MS, et al: Association of transient pure red cell aplasia (PRCA) with chronic viral hepatitis. Clin Res 22:67A, 1974. 2. Havens WP, Marck RE: The leukocytic response of patients with experimentally-induced infectious hepatitis. Am J Med Sci 212:129-138, 1946.Crossref 3. Dische FE, Golding JR: Agranulocytosis associated with infective hepatitis. Br Med J 2:738-740, 1957.Crossref 4. Rubin E, Gottlieb C, Vogel P: Syndrome of hepatitis and aplastic anemia. Am J Med 45:88-97, 1968.Crossref 5. Jurgensen JC, Abraham JP, Hardy WW: Erythroid aplasia after halothane hepatitis: Report of a case. Am J Dig Dis 15:577-581,1970.Crossref 6. Gocke DJ, Howe C: Rapid detection of Australian antigen by counterimmunoelectrophoresis. J Immunol 104:1031-1032, 1970. 7. DeGroote J, Desmet VJ, Gedigk P, et al: A classification of chronic hepatitis. Lancet 2:626-628, 1968.Crossref 8. Rubenstein RA, Yanoff M, Albert DM: Thrombocytopenia, anemia, and retinal hemorrhage. Am J Ophthalmol 65:435-439, 1968. 9. Conrad ME, Weintraub LR, Schwartz FD, et al: Viral hepatitis in Korea: Clinical observations and studies performed during prospective studies to obtain specimens for virologic culture. Prog Liver Dis 2:395-415, 1965. 10. MacIverJE, Parker-Williams EJ: The aplastic crisis in sickle-cell anemia. Lancet 1:1086-1089, 1961.Crossref 11. Gasser C: Aplasia of erythropoiesis . Pediatr Clin North Am 4:445-468, 1957. 12. Lovric VA: Anaemia and temporary erythroblastopaenia in children: A syndrome. Aust Ann Med 19:34-39, 1970. 13. Conklin GT, George JN, Sears DA: Transient erythroid aplasia in hemolytic anemia: A review of the literature with two case reports. Tex Rep Biol Med 32:391-411, 1974. 14. Lafer CZ, Morrison AN: Thrombocytopenic purpura progressing to transient hypoplastic anemia in a newborn with rubella syndrome. Pediatrics 38:499-501,1956. 15. Dooley JR, Burkle JS: Three faces of dengue. Arch Intern Med 117:170-174, 1966.Crossref 16. Tigertt WD, Crosby WH, Berge TO, et al: The virus of Venezuelan equine encephalomyelitis as an antineoplastic agent in man. Cancer 15:628-632, 1962.Crossref 17. Piazza M, Piccinino F, Matano F: Haematological changes in viral (MHV-3) murine hepatitis. Nature 205:1034-1035, 1965.Crossref 18. Hunstein W, Perrings E, Eggeling B, et al: Panmyelophthise und Virushepatitis: Experimentelle Untersuchungen mit dem Mäusehepatitis-Virus MHV3. Acta Haematol 42:336-346, 1969.Crossref 19. Mella B, Lang DJ: Leukocyte mitosis: Suppression in vitro associated with acute infections hepatitis. Science 155:80-81, 1967.Crossref 20. Foy H, Kondi A, MacDougall L: Pure redcell aplasia in marasmus and kwashiorkor treated with riboflavine. Br Med J 1:937-941, 1961.Crossref 21. Alfrey CP, Lane M: The effect of riboflavin deficiency on erythropoiesis. Semin Hematol 7:49-54, 1970. 22. Pezzimenti JF, Lindenbaum J: Megaloblastic anemia associated with erythroid hypoplasia. Am J Med 53:748-754, 1972.Crossref 23. Sherlock S: The immunology of liver disease. Am J Med 49:693-706, 1970.Crossref 24. Krantz SB, Moore WH, Zaentz SD: Studies on red cell aplasia: V. Presence of erythroblast cytotoxicity in γG-globulin fraction of plasma. J Clin Invest 52:324-336, 1973.Crossref 25. Zaentz SD, Krantz SB, Sears DA: Studies on pure red cell aplasia: VII. Presence of proerythroblasts and response to splenectomy: A case report. Blood , to be published. 26. Fanconi G: Familial constitutional panmyelopathy, Fanconi's anemia (F.A.): I. Clinical aspects. Semin Hematol 4:233-240, 1967. 27. Diamond LK, Allen DM, Magill FB: Congenital (erythroid) hypoplastic anemia. Am J Dis Child 102:403-415, 1961.Crossref 28. Nagao T, Mauer AM: Concordance for drug-induced aplastic anemia in identical twins. N Engl J Med 281:7-11, 1969.Crossref 29. Yunis AA: Chloramphenicol-induced bone marrow suppression. Semin Hematol 10:225-234, 1973. 30. Yunis AA, Arimura GK, Lutcher CL, et al: Biochemical lesion in dilantin-induced erythroid aplasia. Blood 30:587-600, 1967. 31. Pisciotta AV: Studies on agranulocytosis: IX. A biochemical defect in chlorpromazine-sensitive marrow cells. J Lab Clin Med 78:435-448, 1971. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Transient Red Blood Cell Aplasia in Association With Viral Hepatitis: Occurrence Four Years Apart in Siblings

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1975.00330120063009
Publisher site
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Abstract

Abstract Various forms of hematopoietic suppression have been reported in viral hepatitis.1 Moderate neutropenia and lymphocytopenia, followed by relative lymphocytosis with reactive lymphocytes, are common in the early stages of the disease,2 and agranulocytosis has been observed.3 Severe, usually fatal, pancytopenia has been described in conjunction with or following hepatitis in at least 30 cases.4 Transient pure erythroid aplasia was observed in a patient with hepatitis attributed to halothane anesthesia.5 In the two patients whose cases are described herein, transient red blood cell (RBC) aplasia with severe anemia was demonstrated during the course of viral hepatitis. Of particular interest is the fact that the patients are siblings whose illnesses occurred four years apart. PATIENT SUMMARIES Patient1. —A 26-year-old man (Table) was first admitted to the Bexar County Hospital on April 5, 1972, because of pain in his left ankle and knee. He had been in References 1. Sears DA, George JN, Gold MS, et al: Association of transient pure red cell aplasia (PRCA) with chronic viral hepatitis. Clin Res 22:67A, 1974. 2. Havens WP, Marck RE: The leukocytic response of patients with experimentally-induced infectious hepatitis. Am J Med Sci 212:129-138, 1946.Crossref 3. Dische FE, Golding JR: Agranulocytosis associated with infective hepatitis. Br Med J 2:738-740, 1957.Crossref 4. Rubin E, Gottlieb C, Vogel P: Syndrome of hepatitis and aplastic anemia. Am J Med 45:88-97, 1968.Crossref 5. Jurgensen JC, Abraham JP, Hardy WW: Erythroid aplasia after halothane hepatitis: Report of a case. Am J Dig Dis 15:577-581,1970.Crossref 6. Gocke DJ, Howe C: Rapid detection of Australian antigen by counterimmunoelectrophoresis. J Immunol 104:1031-1032, 1970. 7. DeGroote J, Desmet VJ, Gedigk P, et al: A classification of chronic hepatitis. Lancet 2:626-628, 1968.Crossref 8. Rubenstein RA, Yanoff M, Albert DM: Thrombocytopenia, anemia, and retinal hemorrhage. Am J Ophthalmol 65:435-439, 1968. 9. Conrad ME, Weintraub LR, Schwartz FD, et al: Viral hepatitis in Korea: Clinical observations and studies performed during prospective studies to obtain specimens for virologic culture. Prog Liver Dis 2:395-415, 1965. 10. MacIverJE, Parker-Williams EJ: The aplastic crisis in sickle-cell anemia. Lancet 1:1086-1089, 1961.Crossref 11. Gasser C: Aplasia of erythropoiesis . Pediatr Clin North Am 4:445-468, 1957. 12. Lovric VA: Anaemia and temporary erythroblastopaenia in children: A syndrome. Aust Ann Med 19:34-39, 1970. 13. Conklin GT, George JN, Sears DA: Transient erythroid aplasia in hemolytic anemia: A review of the literature with two case reports. Tex Rep Biol Med 32:391-411, 1974. 14. Lafer CZ, Morrison AN: Thrombocytopenic purpura progressing to transient hypoplastic anemia in a newborn with rubella syndrome. Pediatrics 38:499-501,1956. 15. Dooley JR, Burkle JS: Three faces of dengue. Arch Intern Med 117:170-174, 1966.Crossref 16. Tigertt WD, Crosby WH, Berge TO, et al: The virus of Venezuelan equine encephalomyelitis as an antineoplastic agent in man. Cancer 15:628-632, 1962.Crossref 17. Piazza M, Piccinino F, Matano F: Haematological changes in viral (MHV-3) murine hepatitis. Nature 205:1034-1035, 1965.Crossref 18. Hunstein W, Perrings E, Eggeling B, et al: Panmyelophthise und Virushepatitis: Experimentelle Untersuchungen mit dem Mäusehepatitis-Virus MHV3. Acta Haematol 42:336-346, 1969.Crossref 19. Mella B, Lang DJ: Leukocyte mitosis: Suppression in vitro associated with acute infections hepatitis. Science 155:80-81, 1967.Crossref 20. Foy H, Kondi A, MacDougall L: Pure redcell aplasia in marasmus and kwashiorkor treated with riboflavine. Br Med J 1:937-941, 1961.Crossref 21. Alfrey CP, Lane M: The effect of riboflavin deficiency on erythropoiesis. Semin Hematol 7:49-54, 1970. 22. Pezzimenti JF, Lindenbaum J: Megaloblastic anemia associated with erythroid hypoplasia. Am J Med 53:748-754, 1972.Crossref 23. Sherlock S: The immunology of liver disease. Am J Med 49:693-706, 1970.Crossref 24. Krantz SB, Moore WH, Zaentz SD: Studies on red cell aplasia: V. Presence of erythroblast cytotoxicity in γG-globulin fraction of plasma. J Clin Invest 52:324-336, 1973.Crossref 25. Zaentz SD, Krantz SB, Sears DA: Studies on pure red cell aplasia: VII. Presence of proerythroblasts and response to splenectomy: A case report. Blood , to be published. 26. Fanconi G: Familial constitutional panmyelopathy, Fanconi's anemia (F.A.): I. Clinical aspects. Semin Hematol 4:233-240, 1967. 27. Diamond LK, Allen DM, Magill FB: Congenital (erythroid) hypoplastic anemia. Am J Dis Child 102:403-415, 1961.Crossref 28. Nagao T, Mauer AM: Concordance for drug-induced aplastic anemia in identical twins. N Engl J Med 281:7-11, 1969.Crossref 29. Yunis AA: Chloramphenicol-induced bone marrow suppression. Semin Hematol 10:225-234, 1973. 30. Yunis AA, Arimura GK, Lutcher CL, et al: Biochemical lesion in dilantin-induced erythroid aplasia. Blood 30:587-600, 1967. 31. Pisciotta AV: Studies on agranulocytosis: IX. A biochemical defect in chlorpromazine-sensitive marrow cells. J Lab Clin Med 78:435-448, 1971.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Dec 1, 1975

References