Hepatitis associated aplastic anemia: case report and discussion

Area of Science:

• Hepatology
• Hematology
• Toxicology

Background:

• Aplastic anemia (AA) is an autoimmune disorder targeting bone marrow precursors.
• Hepatitis-associated aplastic anemia (HAAA) develops after acute hepatitis, often with unidentified causes.
• Viral infections are common triggers, but drug-induced cases are rare.

Observation:

• A young man developed severe aplastic anemia following a transient cholestatic hepatitis.
• The hepatitis was linked to the use of the anabolic steroid methasterone.

Findings:

• This case presents a unique instance of HAAA associated with anabolic steroid use.
• Methasterone induced a cholestatic hepatitis, preceding the development of severe aplastic anemia.

Implications:

• Anabolic steroids should be considered as potential etiological agents in drug-induced aplastic anemia.
• This finding expands the differential diagnosis for HAAA, particularly in individuals with a history of anabolic steroid use.
• Further research is warranted to explore the mechanisms linking anabolic steroids, hepatitis, and bone marrow failure.