Severe Autoimmune Hemolytic Anemia Complicating Treatment-naive Chronic Hepatitis C Infection: A Case Report.

IF 1.5 4区数学 Q3 MATHEMATICS, INTERDISCIPLINARY APPLICATIONS Applied Stochastic Models in Business and Industry Pub Date : 2022-01-01 DOI:10.2174/1871529X22666220418105506

Mahadev Meena, Durga Shankar Meena, Deepak Kumar, Sonu Pandit

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Abstract

Background: Haematological manifestations in Hepatitis C virus (HCV) infection have been uncommon since the advent of direct-acting antiviral drugs (DAAs). However, primary HCV infection can cause significant haematological disease in the form of various autoimmune cytopenias.

Case presentation: We herein discuss a 68-years-old female with chronic HCV infection for the last 15 years (not on the treatment), who presented with complaints of progressive fatigue, exertional dyspnea, and increased abdominal distention over the previous 20 days. Coombs-positive autoimmune haemolytic anaemia (AIHA) was diagnosed based on the haematological evaluation (raised lactate dehydrogenase, indirect bilirubinemia, raised reticulocyte count and direct Coombs positive). The patient showed significant improvement in haematological indices with oral prednisolone. However, she eventually succumbed to her illness due to underlying decompensated liver disease. HCV infection may associate with global derangement of the immune system, which is likely to cause AIHA. Diagnosis of autoimmune cytopenias can be easily missed in HCV positive patients due to underlying decompensated liver disease and portal hypertension.

Conclusion: Thus, screening of HCV infection is imperative in every patient of AIHA, especially with the high worldwide prevalence of HCV.

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严重自身免疫性溶血性贫血并发慢性丙型肝炎非治疗性感染：病例报告。

背景：自直接作用抗病毒药物（DAAs）问世以来，丙型肝炎病毒（HCV）感染的血液学表现并不常见。然而，原发性丙型肝炎病毒（HCV）疾病会以各种自身免疫性细胞减少症的形式引起严重的血液病：我们在此讨论一位 68 岁的女性患者，她在过去 15 年中一直患有慢性 HCV 感染（未接受治疗），主诉在过去 20 天中出现了进行性乏力、劳力性呼吸困难和腹胀加重。根据血液学评估（乳酸脱氢酶升高、间接胆红素血症、网织红细胞计数升高和直接库姆斯阳性），诊断为库姆斯阳性自身免疫性溶血性贫血（AIHA）。口服泼尼松龙后，患者的血液指标有了明显改善。然而，由于潜在的失代偿性肝病，她最终还是不治身亡。HCV感染可能与免疫系统的全面失调有关，而免疫系统失调很可能导致自身免疫性贫血。由于潜在的失代偿性肝病和门静脉高压症，HCV 阳性患者很容易漏诊自身免疫性细胞减少症：因此，对每位 AIHA 患者进行 HCV 感染筛查势在必行，尤其是在全球 HCV 感染率较高的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Stochastic Models in Business and Industry 数学-数学跨学科应用

CiteScore

2.70

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： ASMBI - Applied Stochastic Models in Business and Industry (formerly Applied Stochastic Models and Data Analysis) was first published in 1985, publishing contributions in the interface between stochastic modelling, data analysis and their applications in business, finance, insurance, management and production. In 2007 ASMBI became the official journal of the International Society for Business and Industrial Statistics (www.isbis.org). The main objective is to publish papers, both technical and practical, presenting new results which solve real-life problems or have great potential in doing so. Mathematical rigour, innovative stochastic modelling and sound applications are the key ingredients of papers to be published, after a very selective review process. The journal is very open to new ideas, like Data Science and Big Data stemming from problems in business and industry or uncertainty quantification in engineering, as well as more traditional ones, like reliability, quality control, design of experiments, managerial processes, supply chains and inventories, insurance, econometrics, financial modelling (provided the papers are related to real problems). The journal is interested also in papers addressing the effects of business and industrial decisions on the environment, healthcare, social life. State-of-the art computational methods are very welcome as well, when combined with sound applications and innovative models.