[Immunotherapy in aplastic anaemia as a cause of reactivation of hepatitis B virus-immunologic aspects].
We present history of 16-year-old boy, HBsAg carrier, treated with interferon alpha at the age of 6 because of hepatitis B (HBeAg/antyHBe seroconversion). In August 2002--admitted to Department of Pediatric Oncology due to pancytopenia--diagnosis of severe aplastic anaemia was made (bone marrow cellularity--10%). We found no relative donor for hematopoietic cells transplantation and started immunosuppresive therapy (ATG, G-CSF, methyloprednisolon, cyclosporin). Haematologic parameters were improving. At day +60 he was admitted to our Department due to the increase in aminotransferases and cyclosporin activity. He was treated with cefuroxim, acyclovir and drugs improving liver cell function, cyclosporin was stopped. Presence of HBV DNA in serum confirmed HBV reactivation--a boy received lamivudine and cyclosporin again (as a maintenance therapy of aplastic anaemia). Aminotransferase activity and haematological parameters returned to normal. This case indicates the possibility of HBV reactivation in the course of immunosuppressive therapy (e.g. after antithymocytic globulin and cyclosporin) for aplastic anaemia.
Luczyński
Włodzimierz
W
Kliniki Onkologii Dzieciecej, Akademii Medycznej w Białymstoku. vlodek@am.edu.pl
Muszyńska-Rosłan
Katarzyna
K
Krawczuk-Rybak
Maryna
M
Lebensztejn
Dariusz M
DM
D000741:Anemia, Aplastic / Q000150:complications / Q000276:immunology / Q000628:therapy; D015703:Antigens, CD / Q000276:immunology*; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D016572:Cyclosporine / Q000627:therapeutic use; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D016898:Interferon-alpha / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use
D015703:Antigens, CD; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D016572:Cyclosporine