Successful Treatment of Acute Hepatitis-Associated Aplastic Anemia in a Young Boy: a case report

Acute hepatitis-associated aplastic anemia (AHAAA) is a rare clinical syndrome characterized by the development of aplastic anemia 2-3 months following an episode of acute hepatitis. Several immunosuppressive agents, but not mycophenolate mofetil (MMF), and bone marrow transplantation are the standard treatment options for AHAAA.

In this report, we present a case of a young boy with AHAAA manifesting as acute liver failure. The etiology was type 1 autoimmune hepatitis responsive to the second-line therapeutic combination of steroids and MMF. The liver has fully recovered, but bone marrow failure ensued. After 4 months, Clinical and laboratory improvement occurred without the need for bone marrow transplantation. An important aspect of this case is the full recovery of aplastic anemia without calcineurin inhibitors, anti-thymocyte globulin utilization, or bone marrow transplantation.

Our case history supports MMF as a potentially crucial adjunctive therapy for patients with AHAAA who poorly respond to standard procedures.