Acute hepatitis A-associated aplastic anemia in a pediatric: a case report from Syria.

Introduction and importance: Hepatitis A virus is typically an acute infection that is often asymptomatic, especially in children. In Syria, hepatitis A virus infections are not uncommon. However, the emergence of extrahepatic manifestations, such as aplastic anemia, following hepatitis A infection is unpredictable and challenging to manage, with the connection between these conditions remaining poorly understood. This paper aims to highlight this rare manifestation of aplastic anemia linked to hepatitis A infection in children. Case presentation: We report a rare case of hepatitis-associated aplastic anemia in a 3-year-old Syrian boy who exhibited symptoms of fever, bruising, and mucosal bleeding 1 month after the onset of acute hepatitis. The diagnosis was confirmed via bone marrow examination, and he was treated with immunosuppressives, resulting in full recovery after a year of follow-up with no need for bone marrow transplantation. Clinical discussion: Hepatitis A infection associated with aplastic anemia is an extremely rare condition. Its etiology might be related to the immune system, and its diagnosis is always confirmed with bone marrow biopsy. Treatment includes hematopoietic cell transplantation if the immunosuppressive therapy is not effective. Further research is essential to understand the mechanisms and optimize treatment options. Conclusion: Awareness of the potential association between hepatitis A and aplastic anemia is essential for early diagnosis and effective management. More studies are required to enhance our understanding of the condition and improve therapeutic approaches.