The journey from viral hepatitis to hypocythemia: two case reports Authors Hassan Ur Rehman Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan https://orcid.org/0000-0002-7406-8409 Ayesha Javed Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan https://orcid.org/0000-0002-2551-8733 Nabeel Tariq Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan https://orcid.org/0000-0002-8583-9205 Nida Zeb Abbasi Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan DOI: https://doi.org/10.47391/JPMA.6198020 Abstract Acute viral hepatitis, including hepatitis A, B, E, D, and G, can lead to severe bone marrow suppression due to cytotoxic lymphocytes. The bone marrow suppression causes aplastic anaemia which is mostly unresponsive to immunosuppressive therapy. Such patients require bone marrow transplant for a complete cure. The pancytopenia can evolve during recovery from transaminitis. We are presenting two case reports relating aplastic anaemia with acute viral hepatitis in two young patients—23 and 16 years of age. The 23-year-old female patient had hepatitis A associated with aplastic anaemia whereas the young 16-year-old male patient was diagnosed with Hepatitis E IgG associated aplastic anaemia. Unfortunately, the first patient could not cope with the complications relating to pancytopenia and was unable to reach the bone marrow transplant stage. The second patient did not have a bone marrow transplant but showed an excellent response to immunosuppressive therapy before the transplant and survived. Author Biographies Hassan Ur Rehman, Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan Senior Registrar Department of Internal Medicine & Endocrinology/Diabetology Ayesha Javed, Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan Senior Registrar Department of Internal Medicine & Endocrinology/Diabetology Nabeel Tariq, Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan Resident Department of Internal Medicine & Endocrinology/Diabetology Nida Zeb Abbasi, Department of Internal Medicine and Endocrinology, Pakistan Institute of Medical Sciences / Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan Resident Internal Medicine & Endocrinology/Diabetology Department Downloads Full Text Article Published 2023-02-15 How to Cite Rehman, H. U., Javed, A., Tariq, N., & Abbasi, N. Z. (2023). The journey from viral hepatitis to hypocythemia: two case reports. Journal of the Pakistan Medical Association, 73(2), 419–423. https://doi.org/10.47391/JPMA.6198020 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 73 No. 2 (2023): February Section Case Series