Horse antilymphocytic globulin in hepatitis B exacerbation after bone marrow transplantation adoptive immunity transfer.
We describe the case of a HBsAg+, HBeAg+ carrier, treated with lamivudine, who experienced exacerbation of hepatitis after BMT from an anti-HBs+, anti-HBc+, anti-HBe+ donor. The serological profile of the donor and the timing of exacerbation suggested that the adoptive immunity transfer played a major pathogenetic role. Antilymphocyte globulin administration resulted in resolution of hepatitis and seroconversion to anti-HBs+. Therapy aimed at blocking the effector arm of liver damage could represent a novel approach to avoid the risk of progression to fulminant hepatitis without hampering the chances of recovery from hepatitis B.
Favre
C
C
Unità Trapianto di Midollo, Clinica Pediatrica I, Via Roma 67, 56126 Pisa, Italy. c.favre@med.unipi.it
Menconi
M C
MC
Nardi
M
M
Casazza
G
G
Oliveri
F
F
Macchia
P
P
Bonino
F
F
Brunetto
M R
MR
D019264:Adoptive Transfer; D000818:Animals; D000961:Antilymphocyte Serum / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D018450:Disease Progression; D005260:Female; D006509:Hepatitis B / Q000473:pathology*; D006514:Hepatitis B Surface Antigens / Q000235:genetics*; D006515:Hepatitis B virus / Q000378:metabolism; D006579:Heterozygote; D006650:Histocompatibility Testing; D006736:Horses; D006801:Humans; D016219:Immunotherapy, Adoptive / Q000379:methods*; D019259:Lamivudine / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D013997:Time Factors; D014019:Tissue Donors
D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine