key: cord-0742591-o4ithnrv
authors: Chakravarthy, Rohini; Murphy, Meghan L.; Ann Thompson, Mary; McDaniel, Heather L.; Zarnegar‐Lumley, Sara; Borinstein, Scott C.
title: SARS‐CoV‐2 infection coincident with newly diagnosed severe aplastic anemia: A report of two cases
date: 2021-11-12
journal: Pediatr Blood Cancer
DOI: 10.1002/pbc.29433
sha: 4fde910027180bfa5febb01fb4ce46fd34a89932
doc_id: 742591
cord_uid: o4ithnrv

nan

To the Editor Severe aplastic anemia (SAA) is a rare, life-threatening condition associated with peripheral cytopenias and bone marrow hypocellularity. 1 The pathogenesis of acquired SAA is varied; in some cases, evidence supports immune dysregulation leading to Tcell-mediated destruction of hematopoietic stem cells. 2 Case 2: An 18-year-old male presented with fatigue, headache, and fever. Labs were notable for WBC 2200/µl, ANC 390/µl, ALC 1690/µl, Hgb 3.8 gm/dl, reticulocyte count 18,000/µl, and platelet count 13,000/µl. Pre-admission screening was positive for SARS-CoV-2 via PCR. Bone marrow biopsy showed 10% cellularity without evidence of malignancy ( Figure 1B) , confirming SAA. Extensive evaluation for inherited or acquired etiologies of SAA was unrevealing. He had no siblings and received IST with ATG and cyclosporine. While he has been transfusion independent, he was started on eltrombopag due to refractory thrombocytopenia to 20,000/µl and has had a good response. F I G U R E 1 Initial bone marrow histology for Case 1 (A) and Case 2 (B). The hematoxylin and eosin-stained bone marrow sections at 100× magnification reveal markedly hypocellular marrow of 10% with decreased trilineage hematopoiesis without significant dysplasia, lymphoid aggregates, or increase in blasts

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