[Autoimmune thrombopenia associated with hepatitis B reactivation (reverse seroconversion) after autologous hematopoietic stem cell transplantation].
We report a case of autoimmune thrombocytopenia associated with acute reverse seroconversion of hepatitis B in a patient who was initially hepatitis B virus surface antigen negative and hepatitis B virus surface antibody positive. Reactivation occurred 9 months after chemotherapy with anti-CD 20 monoclonal antibodies and autologous hematopoietic stem cell transplantation for lymphoma had been performed. After non specific polyglobulin injections and treatment with adefovir dipivoxil, thrombocytopenia and viral replication were controlled. Seroconversion for both HBe and HBs occurred at 5 months. Adefovir was stopped 4 months later with no relapse during fifteen months of follow-up. This case shows that patients who have had previous contact with hepatitis B virus should be monitored if they become immunosuppressed, even if anti-HBs were initially present.
Aubourg
Alexandre
A
Service d'Hépato-Gastroentérologie, Hôpital Trousseau, Tours.
d'Alteroche
Louis
L
Senecal
Delphine
D
Gaudy
Catherine
C
Bacq
Yannick
Y
D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D000998:Antiviral Agents / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006509:Hepatitis B / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D006801:Humans; D016867:Immunocompromised Host; D007074:Immunoglobulin G / Q000008:administration & dosage; D007155:Immunologic Factors / Q000008:administration & dosage; D008223:Lymphoma / Q000628:therapy; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D012008:Recurrence; D014182:Transplantation, Autologous / Q000009:adverse effects; D016896:Treatment Outcome
D000998:Antiviral Agents; D007074:Immunoglobulin G; D007155:Immunologic Factors; D063065:Organophosphonates; D000225:Adenine; C106812:adefovir dipivoxil