Hepatitis_Associated_Aplastic_Anemia.pptx

Hepatitis associated aplastic anaemia

1. Hepatitis-Associated Aplastic Anemia (HAAA) Overview, Pathophysiology, Diagnosis, and Treatment

2. Overview • A rare form of bone marrow failure occurring after acute hepatitis • Characterized by pancytopenia due to immune-mediated bone marrow suppression • Most cases are idiopathic, but some are linked to viral infections

3. Etiology (Causes & Risk Factors) • Idiopathic (unknown viral causes) • Hepatitis viruses (mostly non-A, non-B, non-C, non-E) • Autoimmune reactions against bone marrow • Drug-induced hepatitis (antibiotics, NSAIDs, antiepileptics) • Toxin exposure (benzene, pesticides)

4. Pathophysiology 1. Hepatitis or immune trigger initiates T-cell overactivation 2. Activated T cells attack hematopoietic stem cells 3. Bone marrow suppression leads to pancytopenia 4. Severe anemia, infections, and bleeding complications occur

5. Clinical Features • History of recent acute hepatitis (weeks before onset) • Anemia: Fatigue, pallor, breathlessness • Leukopenia: Recurrent infections, fever • Thrombocytopenia: Easy bruising, petechiae, mucosal bleeding • Liver function usually remains intact

6. Diagnosis • Complete Blood Count (CBC): Pancytopenia (low RBCs, WBCs, platelets) • Reticulocyte Count: Low (indicating marrow failure) • Liver Function Tests (LFTs): Mild abnormalities possible • Bone Marrow Biopsy: Hypocellular marrow, absence of malignant cells • Viral Hepatitis Serology: Rule out hepatitis A, B, C, E • Flow Cytometry: Confirms T-cell mediated destruction

7. Treatment Options • First-line Therapy: - Immunosuppressive Therapy (ATG + Cyclosporine) - Hematopoietic Stem Cell Transplantation (HSCT) • Supportive Care: - Blood transfusions - Growth factors (e.g., G-CSF) - Antibiotics/antifungals for infection prevention

8. Prognosis & Outcomes • Survival rates improved with IST and HSCT (up to 80% in young patients) • Relapse is possible, requiring second-line therapy • Long-term risks: Myelodysplastic syndrome, leukemia • Without treatment, prognosis is poor

9. Key Takeaways • HAAA is a rare, severe complication of acute hepatitis • Immune-mediated destruction of bone marrow leads to pancytopenia • Diagnosis requires CBC, bone marrow biopsy, and viral serology • HSCT is curative; immunosuppressive therapy is an alternative • Early treatment significantly improves survival