儿童肝炎相关性再生障碍性贫血8例临床特征

Clinical characteristics of 8 children with hepatitis related aplastic anemia

目的了解儿童肝炎相关性再生障碍性贫血(HAAA)的临床特点。方法回顾性分析2019年7月—2021年6月于河北省儿童医院住院治疗的8例HAAA患儿的临床资料。结果8例患儿发病初期以胆汁淤积为主要表现,外周血常规基本正常,经保肝、降酶治疗后肝功能指标渐好转,逐渐出现全血细胞减少,骨髓穿刺确诊再生障碍性贫血。由肝炎发展为再生障碍性贫血平均时间为42.2天。8例患儿均存在免疫功能紊乱,治疗以免疫抑制剂为主。结论儿童HAAA多发生于急性肝炎或慢性感染恢复期,存在免疫功能紊乱;治疗以免疫抑制剂为主。

Objective To analyze the clinical characteristics of hepatitis-associated aplastic anemia(HAAA)in children.Methods Clinical data of 8 children with HAAA hospitalized in Hebei Children's Hospital from July 2019 to June 2021 were retrospectively analyzed.Results In the early stage of the disease,cholestasis was the main manifestation,and the peripheral blood was basically normal.After liver protection and enzyme lowering therapy,the liver function indexes gradually improved,but the peripheral blood gradually developed pancytopenia,and bone marrow aspiration confirmed the diagnosis of aplastic anemia.The average duration from hepatitis to aplastic anemia development was 42.2 days.All 8 children have had immune dysfunction.Immunosuppressive agent is the main treatment.Conclusions HAAA mainly occurs in the convalescent period of acute hepatitis or chronic infection in children.There is immune dysfunction in patients with HAAA.Immunosuppressive agents are used to treat the disease.