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  • Pernicious anemia in case of Chronic Viral Hepatitis infection
    Hepatitis Monthly, 2011
    Co-Authors: Emmanuel Andrès, Mustapha Mecili, Ecaterina Ciobanu
    Abstract:

    Leonardi and Rosa’s (2010) research on the link between celiac disease and Viral Hepatitis (1) is well designed and fo-cuses on a very interesting topic. Several de novo or latent autoimmune disorders or diseases have been reported in cases of Chronic Viral Hepatitis infections, especially Hepati-tis C (2). In this paper, we report 5 cases of established perni-cious anemia during Chronic Viral Hepatitis infection. These cases were extracted from a retrospective (1996 to 2010) study of 82 cases of pernicious anemia in the University Hospital of Strasbourg, France, a tertiary reference center (personal communication in the French Congress of He-matology, Paris, December, 2010). Clinical characteristics of the 5 patients are described in

  • Pernicious anemia in case of Chronic Viral Hepatitis infection: Pernicious anemia and Chronic Viral Hepatitis
    Hepatitis monthly, 2011
    Co-Authors: Emmanuel Andrès, Mustapha Mecili, Ecaterina Ciobanu
    Abstract:

    Dear Editor, Leonardi and Rosa's (2010) research on the link between celiac disease and Viral Hepatitis [1] is well designed and focuses on a very interesting topic. Several de novo or latent autoimmune disorders or diseases have been reported in cases of Chronic Viral Hepatitis infections, especially Hepatitis C [2]. In this paper, we report 5 cases of established pernicious anemia during Chronic Viral Hepatitis infection. These cases were extracted from a retrospective (1996 to 2010) study of 82 cases of pernicious anemia in the University Hospital of Strasbourg, France, a tertiary reference center (personal communication in the French Congress of Hematology, Paris, December, 2010). Clinical characteristics of the 5 patients are described in table 1, particularly details on Hepatitis infection, modalities of the interferon-alpha treatment, and data on the cobalamin deficiency related to the pernicious anemia. Data of 3 patients were previously published in the literature [3]. It is important to note that, in one case, an association was found between pernicious anemia, true celiac disease, and Chronic actve Hepatitis C infection. All the patients were successfully treated with regular intramuscular cyanocobalamin therapy (despite continuous administration of interferon-alpha in 2 cases). To the best of our knowledge, there are only a relatively small amount of cases (< 10 in our own data) documenting a relationship between symptomatic pernicious anemia and Viral Hepatitis infections. Our patients had established pernicious anemia with documented cobalamin deficiency (in accordance with recent criteria; [4]). They alsfo have a clear Chronic active Viral Hepatitis infection on liver biopsy (1 case of Hepatitis B and 4 cases of Hepatitis C). Moreover, one of our patients had a well-documented case of celiac disease with malabsorption and antitransglutamise antibodies, partially cured with nutritional restrictions (no gluten intake). The pathogenis (the link) of this association is not well knownf, but the role of the virus or of the interferon-alpha treatment as an immuno-modulatory agent is possible [5]. However in our opinion, the fact that this association is exceptional led to the suspicion of a fortuitous association. Thus before any conclusions can be made, future studies similar to Leaonardi and Rosa (2010) are required. Nevertheless, it is important to be aware of the possibility of the association between pernicious anemia and Chronic Viral Hepatitis infections because recognition of this association can help prevent severe cobalamin deficiency. Table 1 Characteristics of the patients

Galip Akhan - One of the best experts on this subject based on the ideXlab platform.

Yavuz Bardak - One of the best experts on this subject based on the ideXlab platform.