Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Eur J Pediatr. 2010 Jul;169(7):899-902. doi: 10.1007/s00431-009-1116-8. Epub 2009 Dec 9.
A 12-year-old Japanese boy suffered from severe acute hepatitis and pancytopenia. The patient underwent successful bone marrow transplantation from an HLA-identical sister. Torque teno virus (TTV) DNA of genotype 1a and IgM-class antibody against the virus were detected in sera at the onset of hepatitis. TTV/1a DNA and anti-TTV/1a IgM antibody levels were undetectable on the 16th and 46th days after the onset of illness, respectively. Anti-TTV/1a IgG antibody was positive throughout the observation period. Sequential viral load and anti-TTV/1a IgM antibody suggested a primary infection of TTV/1a. Genomic sequence of the virus coincided with that of the original strain first isolated from human. TTV DNA was quantified at 130 copies in 10(5) bone marrow mononuclear cells, which suggested that infection of hematopoietic cells might be the cause of aplasia. This is the first report of TTV hepatitis-associated aplastic anemia assessed by the anti-TTV antibodies and viral load in peripheral blood and bone marrow.
一名 12 岁日本男孩患有严重急性肝炎和全血细胞减少症。该患者接受了与 HLA 相同的姐姐的骨髓移植，手术成功。在肝炎发作时，患者血清中检测到基因型 1a 的扭转型病毒（TTV）DNA 和针对该病毒的 IgM 类抗体。在发病第 16 天和第 46 天，分别检测不到 TTV/1a DNA 和抗 TTV/1a IgM 抗体。整个观察期间，抗 TTV/1a IgG 抗体呈阳性。病毒载量和抗 TTV/1a IgM 抗体的连续检测提示 TTV/1a 的原发性感染。病毒的基因组序列与从人源中首次分离的原始株一致。在 10(5)骨髓单核细胞中定量检测到 TTV DNA 为 130 拷贝，这表明造血细胞感染可能是导致再生障碍的原因。这是通过外周血和骨髓中的抗 TTV 抗体和病毒载量评估的 TTV 肝炎相关性再生障碍性贫血的首例报告。
