Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature
| Autor: | Fan-Jun Meng, Bo Ju, Li Zhao, Xiao-Yun Sun, Xi-Chen Zhao, Zeng-Shan Xu, Hong-Guo Zhao |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Gut inflammation
medicine.medical_specialty Severe aplastic anemia business.industry education Hematological response macromolecular substances General Medicine Severe Aplastic Anemia Gastroenterology humanities 03 medical and health sciences 0302 clinical medicine Comorbid disease hemic and lymphatic diseases 030220 oncology & carcinogenesis Internal medicine Case report Etiological association Medicine 030211 gastroenterology & hepatology Chronic gut inflammation business |
| Zdroj: | World Journal of Clinical Cases |
| ISSN: | 2307-8960 |
| DOI: | 10.12998/wjcc.v8.i2.425 |
| Popis: | BACKGROUND Cumulative evidence suggests that the aberrant immune responses in acquired aplastic anemia (AA) are sustained by active chronic infections in genetically susceptible individuals. Recently, the constant source to trigger and sustain the pathophysiology has been proposed to come from the altered gut microbiota and chronic intestinal inflammation. In this case, our serendipitous finding provides convincing evidence that the persistently dysregulated autoimmunity may be generated, at least in a significant proposition of AA patients, by the altered gut microbiota and compromised intestinal epithelium. CASE SUMMARY A 30-year-old Chinese male patient with refractory severe AA experienced a 3-month-long febrile episode, and his fever was refractory to many kinds of injected broad-spectrum antibiotics. When presenting with abdominal cramps, he was prescribed oral mannitol and gentamycin to get rid of the gut infection. This treatment resulted in a quick resolution of the fever. Unanticipatedly, it also produced an excellent hematological response. He had undergone three episodes of recurrence within the one-year treatment, with each recurrence occurring 7-8 wk from the gastrointestinal inflammation eliminating preparations. However, subsequent treatments were able to produce subsequent remissions and consecutive treatments were successful in achieving durative hematological improvements, strongly indicating an etiological association between chronic gut inflammation and the development of AA. Interestingly, comorbid diseases superimposed on this patient (namely, psychiatric disorders, hypertension, insulin resistance, and renal dysfunction) were ameliorated together with the hematological improvements. CONCLUSION Chronic gut inflammation may be responsible for AA pathogenesis. The comorbidities and AA may share a common etiological association. |
| Databáze: | OpenAIRE |
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