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1例严重急性甲型肝炎合并纯红细胞再生障碍性贫血。

A case of severe acute hepatitis a complicated with pure red cell aplasia.

作者信息

Lim Pyoung Suk, Kim In Hee, Kim Seong Hun, Lee Seung Ok, Kim Sang Wook

机构信息

Department of Internal Medicine, Research Institute of Clinical Medicine, Chonbuk National University Medical School, Jeonju, Korea.

出版信息

Korean J Gastroenterol. 2012 Sep 25;60(3):177-81. doi: 10.4166/kjg.2012.60.3.177.

Abstract

Hepatitis A is typically a self-limited acute illness that does not progress to chronic hepatitis. In rare cases, acute hepatitis A can be associated with serious complications (such as fulminant hepatitis or acute kidney injury) and may result in death or liver transplantation. Pure red cell aplasia (PRCA) is a rare hematologic disorder characterized by anemia, reticulocytopenia in the blood, and isolated erythroblastopenia with normal granulopoiesis and megakaryopoiesis in the bone marrow. PRCA is a rare hematopoietic complication of acute viral hepatitis, and few cases associated with hepatitis A virus infection have been reported. Recently, we experienced a case of severe hepatitis A complicated by fulminant hepatitis and acute kidney injury followed by PRCA which showed a favorable response to oral corticosteroids.

摘要

甲型肝炎通常是一种自限性急性疾病,不会发展为慢性肝炎。在罕见情况下,急性甲型肝炎可伴有严重并发症(如暴发性肝炎或急性肾损伤),并可能导致死亡或肝移植。纯红细胞再生障碍性贫血(PRCA)是一种罕见的血液系统疾病,其特征为贫血、血液中网织红细胞减少,以及骨髓中粒细胞生成和巨核细胞生成正常但孤立性成红细胞减少。PRCA是急性病毒性肝炎罕见的造血系统并发症,与甲型肝炎病毒感染相关的病例报道较少。最近,我们遇到一例严重甲型肝炎并发暴发性肝炎和急性肾损伤,随后发生PRCA的病例,该病例对口服皮质类固醇治疗反应良好。

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