Anemia hemolítica autoinmune postinfección por virus de la hepatitis A. Informe de caso.
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| Title: | Anemia hemolítica autoinmune postinfección por virus de la hepatitis A. Informe de caso. |
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| Alternate Title: | Autoimmune haemolytic anaemia associated to hepatitis A. Case report. |
| Authors: | Melo, Claudia Lucía Sossa1,2 claudiasossa@gmail.com, Sanguino, Sara Inés Jiménez1, Martínez, Carlos Andrés Pérez1, Vergara, Amaury Alexis Amaris3, Montaña, Luis Antonio Salazar1,2, Castellanos, Ángela Peña1, Ramírez, Jesica Liliana Pinto4, Arenas, Laura Andrea Rincón4 |
| Source: | MedUNAB. dic2010, Vol. 13 Issue 3, p173-176. 4p. 1 Graph. |
| Subjects: | HEMOLYTIC anemia, HEPATITIS A, AUTOIMMUNE diseases, GLUCOSE-6-phosphate dehydrogenase deficiency, HEMOLYSIS & hemolysins, DISEASE risk factors |
| Abstract (English): | Acute auto inmune haemolytic anaemia is associated with a variety of hepatotropic viruses, in particular cytomegalovirus, Epstein Barr virus and hepatitis B. The typical course of hepatitis A is rarely complicated with glucose-6-phosphate dehydrogenase deficiency. We present the case of a man without previous haemolysis, he had been unwell for two months with fatigue and jaundice, the liver edge was palpable and tender 14 cm below the costal margin. Clinical chemistry showed haemolytic anaemia with positive direct coombs test, immunoglobulin M antibodies to hepatitis A virus were detected, the total bilirrubin concentration 20 times the upper and transaminase 4 times upper limit for normal levels; with this finds the case was diagnosed hepatitis A complicated by haemolytic anaemia and associated with probable autoimmune hepatitis, therefore was started treatment with corticosteroids, over the following week he gradually improved clinically. We described the importance rule out hepatitis A viral infection as possible etiology for haemolytic anaemia. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | La anemia hemolítica autoinmune se asocia con una variedad de virus hepatotrópicos, en particular citomegalovirus (CMV), virus del Epstein-Barr y de la hepatitis B. No es frecuente dentro de la historia natural de la hepatitis A, la aparición de anemia hemolítica, y cuando se presenta, generalmente se asocia a deficiencia de glucosa-6-fosfato deshidrogenasa. Presentamos el caso de un paciente de sexo masculino sin hemólisis previa, con astenia e ictericia de dos meses de evolución y hepatomegalia 14 cm por debajo del reborde costal derecho. Los hallazgos en los exámenes de laboratorios mostraron anemia hemolítica con Coombs directo positivo, anticuerpos tipo inmunoglobulina M contra el virus de la hepatitis A positivos, niveles de bilirrubinas 20 veces y aminotrasferasas cuatro veces por arriba del rango normal; con estos datos el paciente fue diagnosticado como hepatitis A complicada con anemia hemolítica y probable hepatitis autoinmune asociada, por lo que se inició manejo con corticoides, alcanzándose mejoría clínica. Resaltamos la importancia de descartar la infección por el virus de la hepatitis Acomo posible etiología de anemia hemolítica autoinmune. [ABSTRACT FROM AUTHOR] |
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| Database: | MedicLatina |
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