血小板輸血後,B型肝炎を発症した再生不良性貧血症例の検討

摘要

We report a patient with hepatitis B and aplastic anemia who was infected with donor hepatitis B virus during the so-called window period. A 22-year-old man was found to be anemic at age 7 and diagnosed as having aplastic anemia. He was given oxymetholon 25~50mg/day for 14 years (total 226 g). On August 3, 1995, a hepatic tumor developed as a complicated of anabolic steroid use. He had a liver biopsy on October 24, 1996. To prevent bleeding, he was received platelet concentrate (PC) transfusions at 20 units on October 23, 1996, 20 units on the 24, and 10 units on the 25. Histological findings suggested hepatic adenoma. Eleven weeks after PC transfusion,S-GPT became elevated, so donor's blood was tested at the Japanese Red Cross Central Blood Center.HBV-DNA was positive by the nested PCR method in retained donor blood. At 16 weeks after PC transfusion, the patient's laboratory data were as follows: HBsAg and HBcAb were positive,HBsAb was negative, S-GOT was 236 IU/L and S-GPT was 695 IU/ L.These values have since steadily improved, and bone marrow transplantation will be carried out after recovery.Recently, the incidence of post-transfusion hepatitis has decreased. Further reduction in risk will be obtained through the introduction of more sensitive screening tests,such as HBsAg (ElA) and PCR methods, and the registration of screened donors.