Zhao XC, Zhao L, Sun XY, Xu ZS, Ju B, Meng FJ, Zhao HG. Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature. World J Clin Cases 2020; 8(2): 425-435 [PMID: 32047795 DOI: 10.12998/wjcc.v8.i2.425]
Corresponding Author of This Article
Hong-Guo Zhao, MD, Professor, Chief, Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao 266000, Shandong Province, China. zhaohongguo6201@163.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 26, 2020; 8(2): 425-435 Published online Jan 26, 2020. doi: 10.12998/wjcc.v8.i2.425
Excellent response of severe aplastic anemia to treatment of gut inflammation: A case report and review of the literature
Xi-Chen Zhao, Li Zhao, Xiao-Yun Sun, Zeng-Shan Xu, Bo Ju, Fan-Jun Meng, Hong-Guo Zhao
Xi-Chen Zhao, Li Zhao, Xiao-Yun Sun, Zeng-Shan Xu, Bo Ju, Department of Hematology, The Central Hospital of Qingdao West Coast New Area, Qingdao 266555, Shandong Province, China
Fan-Jun Meng, Hong-Guo Zhao, Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Author contributions: Zhao XC, Zhao L, and Sun XY drafted the manuscript; Zhao XC, Zhao L, Sun XY, Xu ZS, and Ju B participated in the treatment of this patient; Meng FJ and Zhao HG supervised the treatment and revised the manuscript; all authors approved the final version of the manuscript.
Informed consent statement: Written informed consent was obtained from the patient for publishing this report and any accompanying laboratory data.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hong-Guo Zhao, MD, Professor, Chief, Department of Hematology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao 266000, Shandong Province, China. zhaohongguo6201@163.com
Received: November 8, 2019 Peer-review started: November 8, 2019 First decision: November 19, 2019 Revised: December 2, 2019 Accepted: December 21, 2019 Article in press: December 21, 2019 Published online: January 26, 2020 Processing time: 70 Days and 2.6 Hours
Core Tip
Core tip: The aberrant immune responses in aplastic anemia had been proposed to be triggered by altered gut microbiota, and our serendipitous finding that a 30-year-old man with refractory severe aplastic anemia had gained an inadvertently excellent hematological response following oral administration of mannitol and gentamycin provides convincing evidence to support the hypothetical but plausible pathogenic association. Several comorbid diseases on this patient were ameliorated together with the hematological improvements, indicating commonly shared etiological associations between the comorbidities and aplastic anemia in a background consisting of altered gut microbiota, chronic intestinal inflammation, increased epithelial permeability, and an autoimmune nature, instead of the adverse events of cyclosporine and iron overload.
