A case of hepatitis-associated aplastic anemia complicated by hemophagocytic lymphohistiocytosis and literature review

ZHOU Xin; CHEN Xiao-Yu; WEN Chuan; LUO Sen-Lin

doi:10.7499/j.issn.1008-8830.2409118

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Chinese Journal of Contemporary Pediatrics ›› 2025, Vol. 27 ›› Issue (4) : 465-471. DOI: 10.7499/j.issn.1008-8830.2409118

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A case of hepatitis-associated aplastic anemia complicated by hemophagocytic lymphohistiocytosis and literature review

ZHOU Xin, CHEN Xiao-Yu, WEN Chuan, LUO Sen-Lin

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Abstract

A 4-year-old boy was admitted to the hospital with a 3-day history of rash and intermittent abdominal pain, during which abnormal results from routine blood tests were discovered. Initially, he presented with acute jaundice hepatitis and pancytopenia. The patient's condition progressed rapidly, with recurrent fever, worsening jaundice of the skin and sclera, and progressively worsening hepatosplenomegaly. Liver function impairment and bone marrow failure continued to deteriorate, while cytokine levels continued to rise. After excluding infections, autoimmune diseases, tumors, genetic metabolic disorders, and toxicities, the patient was diagnosed with hepatitis-associated aplastic anemia (HAAA) complicated by hemophagocytic lymphohistiocytosis (HLH). Following treatment with corticosteroids, plasma exchange, intravenous immunoglobulin, and liver protection therapy, the patient's symptoms partially alleviated. Aplastic anemia complicated by HLH is relatively uncommon, and HAAA complicated by HLH is even rarer, often presenting insidiously and severely. This paper presents a case of HAAA complicated by HLH and summarizes previously reported cases in the literature, providing references for the early diagnosis and treatment of this condition.

Key words

Hepatitis-associated aplastic anemia / Hemophagocytic lymphohistiocytosis / Child

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ZHOU Xin, CHEN Xiao-Yu, WEN Chuan, LUO Sen-Lin. A case of hepatitis-associated aplastic anemia complicated by hemophagocytic lymphohistiocytosis and literature review[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(4): 465-471 https://doi.org/10.7499/j.issn.1008-8830.2409118

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