- 期刊
Acute Exacerbation of Chronic Hepatitis B Complicated with Pure Red Cell Aplasia: Report of a Case
慢性B型肝炎急性發作併發純粹紅血球發育不全
摘要
純粹紅血球發育不全(Pure red cell aplasia)爲血液學之症候群，其特徵爲嚴重貧血，骨髓中缺少紅血球前導細胞。純粹紅血球發育不全可以發生在急性病毒感染之後，例如微小病毒B9型(Parvovirus B9)、A型肝炎病毒感染，然而純粹紅血球發育不全目前仍無報告與慢性B型肝炎相關。免疫抑制劑爲治療純粹紅血球發育不全的主要方式，但是免疫抑制劑會活化B型肝炎病毒的複製。我們報告一位64歲女性在慢性B型肝炎急性發作之後產生重度貧血，骨髓生檢發現爲純粹紅血球發育不全，病理結果顯示此純粹紅血球發育不全爲免疫作用所導致，然而此病例的貧血並不需依賴免疫抑制劑治療，可以經輸血處理得到控制。
並列摘要
Pure red cell aplasia (PRCA) is a haematological syndrome characterize by profound anemia and absence of erythroid precursors in the bone marrow. It sometimes occurs after the onset of acute viral infection, such as human parvovirus strain B19, or hepatitis A virus infection. However, there is no report regarding PRCA in chronic hepatitis B virus (HBV) infection. Immunosuppressive therapy is the mainstay treatment for patients with PRCA, but immunosuppressant can activate HBV replication. We reported a case of 64-year-old female patient who manifested with life-threatening anemia during the recovery phase after an episode of acute exacerbation of chronic hepatic B. Bone marrow biopsy revealed to be pure red cell aplasia. Even though the pathological finding suggested that it was immune-mediated, the episode of PRCA in the case was not immunosuppressant-dependent and could be managed by blood transfusion.
延伸閱讀
- 廖運範（1986）。慢性B型肝炎急性發作。中華民國消化系醫學會雜誌，3(1)，1-1。https://www.airitilibrary.com/Article/Detail?DocID=a0000204-198603-3-1-1-1-a
- Chen, J. S., Young, T. H., Chao, Y. C., Tang, H. S., Yan, J. C., Chen, Y. C., & Lee, H. S. (1998). 反應性血球吞噬症候群在急性B型肝炎之病患－病例報告. 中華民國消化系醫學雜誌, 15(1), 8-13. https://doi.org/10.6557/GJTb.199803_15(1).0002
- 羅錦河（2004）。慢性B型肝炎急性發作?。健康世界，(228)，92-97。https://doi.org/10.6454/HW.200412.0092
- Lin, T. S., & Hsu, P. N. (2014). 全身性紅斑狼瘡患者的乙型肝炎盛行率偏低但伴隨較高比率的肝衰竭與肝癌. Formosan Journal of Rheumatology, 28(1), 53-59. https://doi.org/10.6313/FJR.2014.28(01).08
- Chu, Y. C., Wu, C. S., Yang, C. C., Lui, Y. T., Lam, K. L., & Chen, C. H. (2002). C型肝炎接受合併療法併發自體免疫溶血性貧血：一病例報告. 臺灣消化醫學雜誌, 19(3), 209-214. https://doi.org/10.6557/GJT.200209_19(3).0006