Fulminant hepatitis following bone marrow transplantation in hepatitis B virus carrier siblings.
A 19-year-old male healthy hepatitis B virus (HBV) carrier developed fulminant hepatitis following allogenic bone marrow transplantation (BMT) from his brother, who was also a healthy HBV carrier, during the first complete remission of acute myelogenic leukemia (M1, FAB classification). Serum markers related to both HBV and hepatitis C virus (HCV) were elevated during active liver injury when a point mutation in the precore (pre-C) region occurred in the HBV. The patient received low-dose interferon alpha (IFN-alpha), while the dose of cyclosporin A was tapered; the patient eventually recovered from the liver injury. Fulminant hepatitis due to HBV and/or HCV following BMT is rare, and it is considered to have a very poor prognosis. The rationale for the use of low-dose IFN-alpha with cyclosporin A (CyA) is discussed.
Omata
F
F
Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan.
Ueno
F
F
Kushibiki
Y
Y
Takahashi
H
H
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002353:Carrier State; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male
D016898:Interferon-alpha; D016572:Cyclosporine