Resolution of chronic hepatitis B-associated autoimmune neutropenia with interferon-alpha therapy.
Resolution of chronic hepatitis B-associated autoimmune neutropenia with interferon-alpha therapy.
复制标题
用干扰素-α 治疗解决慢性乙型肝炎相关的自身免疫性中性粒细胞减少症。
DOI：
10.1097/00005176-200301000-00027
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发表时间：
2003
影响因子：
2.9
通讯作者：
Hoofnagle,JayH
中科院分区：
文献类型：
--
作者：
Soza,Alejandro;Lau,DarylT-Y;Khokhar,MuhammadFarooq;Conjeevaram,Hari;Park,Yoon;Hoofnagle,JayH
DISCUSSIONNeutropenia can accompany viral hepatitis due to several causes. The most common cause is hypersplenism resulting from cirrhosis and portal hypertension. The neutropenia of cirrhosis often complicates therapy with IFN-because this cytokine has dose-related myelosuppressive activity that decreases neutrophil counts by 30% to 50%. In patients with preexisting neutropenia, neutrophil counts may decrease to fewer than 500 cells/mm3 during therapy and lead to dose modification or early discontinuation of therapy. More rarely, neutropenia can be a complication of hepatitis in the absence of cirrhosis. This complication occurs usually in patients with acute viral hepatitis. Thus, there is a well-documented association between severe acute hepatitis of unknown cause (presumably a non–AE hepatitis virus) and pancytopenia (aplastic anemia)(7). Typically, this syndrome presents acutely and has a high mortality rate unless there is prompt treatment with immunosuppressive agents, such as antithymocyte globulin and cyclosporine, or bone marrow transplantation. Although this syndrome is generally believed to be caused by infection with a hepatitis virus, it may actually be autoimmune in nature. This possibility is supported by the prompt clinical response to immunosuppressive management and also by in vitro studies showing that peripheral blood and marrow cells and their supernatants from affected patients can suppress hematopoiesis by autologous and normal marrow (8). Rarely, isolated neutropenia without changes in erythrocyte or platelet counts has been associated with acute hepatitis. In contrast to our case, the few published reports have been associated with a hypocellular bone marrow or maturational arrest of the myeloid series (9–12). HBV has been implicated in two cases of hepatitis-
