Hepatitis Associated Aplastic Anemia (HAAA): A Rare Case of Severe Aplastic Anemia Following Acute Viral Hepatitis A

Abstract

Hepatitis-associated aplastic anemia (HAAA) is acquired aplastic anemia in which marrow failure follows the development of hepatitis. HAAA was first described in 1955. It usually affects children and young adolescents. Immune mediated liver injury and bone marrow failure with involvement of activated lymphocytes may be proposed mechanism. We report a case of 17 year old female child who presented with fever, vomiting and yellow discoloration of urine with pallor and jaundice with pancytopenia. In our case report, Positive IgM Anti-HAV with aplastic bone marrow is found which is a rare association. Other viral markers are negative. Untreated HAAA has high mortality. HAAA has a very poor outcome. Management includes immunosuppression and anti-thymocyte globulin and ultimately bone marrow transplantation (BMT) may be required.