A Transfusion-transmitted Chronic Hepatitis E Virus Infection after Allogeneic Bone Marrow Transplantation with Viral Clearance Following Immunosuppression Tapering.
Keijiro Sato, Hiroko Kazumoto, Ami Tanaka et al.
✦ AI-curated · Sources linked
Case in brief
A 62-year-old woman with myelofibrosis developed liver dysfunction after allogeneic bone marrow transplantation. Testing showed anti-HEV IgA and HEV RNA, and matching viral RNA sequences in the transfusion donor and recipient supported transfusion-transmitted genotype 3 infection. Liver dysfunction began two months after transfusion and worsened while tacrolimus was escalated for suspected graft-versus-host disease. It resolved after tacrolimus was tapered, without another intervention reported.
What made this case unusual
The case linked chronic HEV infection to transfusion using matching donor and recipient viral RNA sequences; liver dysfunction also resolved with tacrolimus tapering alone.
Diagnostic / clinical pearl
Consider HEV in post-transplant liver dysfunction, including when transfusion is a possible source and graft-versus-host disease is suspected.