Evidence map›Paper›PMID 41363020›Full record

ArticleJournal of pediatric gastroenterology and nutrition2026

Acute severe cholestatic hepatitis and lymphopenia characterize pediatric hepatitis-associated aplastic anemia.

Daniel Tegtmeyer, Sofia Tsaka, Kai Lehmberg, Michaela Höfs, Jan Beime, Andrea Briem-Richter, Jun Oh, Elke Lainka, Sebastian Schulz-Jürgensen

Abstract readMulticenter Study
In one paragraph

Article in Journal of pediatric gastroenterology and nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Daniel TegtmeyerDepartment of Pediatric Nephrology, Hepatology and Transplantation, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID https://orcid.org/0000-0002-7867-0069
Sofia TsakaDepartment of Paediatrics II, University Children's Hospital, Pediatric Gastroenterology, Hepatology, and Transplant Medicine, University Duisburg-Essen, Essen, Germany.
Kai LehmbergEuropean Reference Network for Hepatological Diseases (ERN RARE-LIVER), Hamburg, Germany.
Michaela HöfsDepartment of Pediatrics III, University Children's Hospital, Pediatric Hematology and Oncology, University Duisburg-Essen, Essen, Germany.
Jan BeimeDepartment of Pediatric Nephrology, Hepatology and Transplantation, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Andrea Briem-RichterDepartment of Pediatric Nephrology, Hepatology and Transplantation, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Jun OhDepartment of Pediatric Nephrology, Hepatology and Transplantation, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Elke LainkaDepartment of Paediatrics II, University Children's Hospital, Pediatric Gastroenterology, Hepatology, and Transplant Medicine, University Duisburg-Essen, Essen, Germany.
Sebastian Schulz-JürgensenDepartment of Pediatric Nephrology, Hepatology and Transplantation, University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Funding

None
6 · The paper itself

Abstract

objectivesHepatitis-associated aplastic anemia (HAAA) is described as acute severe hepatitis of unknown origin followed by bone marrow failure (BMF). We aimed to provide a comprehensive picture of pediatric HAAA.

methodsTwo-center retrospective analysis was performed using data from children diagnosed with acquired BMF, including severe aplastic anemia (SAA) and myelodysplastic syndrome type refractory cytopenia of childhood (RCC). The assessment of the subcohort of HAAA included clinical features indicative of diagnosis and disease progression, with additional data from previously published case series.

resultsCohort comprised 62 children with acquired BMF and 22 children with HAAA. Median age of HAAA patients was 13.5 years. Potentially triggering viral infections were detected in 45%. The median interval from hepatitis onset to cytopenia was 3 weeks. All cases presented with severe hepatitis (median alanine transaminase 2127 U/L) and all but one with hyperbilirubinemia (median bilirubin 15.3 mg/dL). Coagulopathy was variable (median international normalized ratio 1.5). Four patients (18%) developed acute liver failure, two (9%) required liver transplantation. Hepatic parameters normalized within a median of 8.5 weeks. There was no statistically significant difference in the course of hepatitis between patients with SAA and RCC. Early lymphopenia was a key finding in patients with HAAA, progressing from a median of 905/µL at hepatitis onset to 530/µL within 4 weeks.

conclusionsHAAA occurs in both SAA and RCC. Most cases present with severe acute cholestatic hepatitis and variable coagulopathy. Hepatic recovery is common. Lymphopenia at disease onset is frequent and may serve as a diagnostic marker.

Indexed as

Anemia, AplasticCholestasisHepatitisLymphopeniaAcute DiseaseAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesSeverity of Illness Indexacute liver failureacute severe hepatitisbone marrow failure

Identifiers

PMID41363020
PMCPMC12864175

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.