Collection of Biological Samples From Patients With Hepatitis-Associated Aplastic Anemia
Condition: Hepatitis-Associated Aplastic Anemia
MeSH terms: Hepatitis A; Hepatitis; Anemia; Anemia, Aplastic
Study type: Observational

Summary: 
      This study will collect samples of blood, stool, bone marrow, or other tissues from patients
      with hepatitis-associated aplastic anemia to investigate a possible association between
      exposure to viruses and the development of aplastic anemia in these patients. Cells from the
      samples obtained may be grown in the laboratory for future studies. Patients samples may be
      used to:

        -  Study abnormalities that occur in hepatitis-associated aplastic anemia;

        -  Test for various viruses;

        -  Test immune function;

        -  Measure factors related to the patients disease or diseases they may be at risk for;

        -  Evaluate the effectiveness of current therapies, refine treatment approaches, and
           identify potential new therapies;

        -  Identify possible measures for disease prevention;

        -  Identify possible genetic factors associated with hepatitis-associated aplastic anemia.

      Patients 2 years of age and older with severe aplastic anemia that developed within 6 months
      of an episode of hepatitis may be eligible for this study.

      Participants will complete questionnaires and provide tissue samples as described below.

      Questionnaires

      All patients (or another respondent for the patient) will fill out a questionnaire including
      demographic information (age, gender, race, ethnic group, education level, state of
      residence), current symptoms, medications, medical history, and history of possible exposures
      to toxins or viruses. A second questionnaire, which includes questions related to mental
      health, sexual behavior, alcohol and drug use, is optional for participants age 21 and older.
      These questionnaires are designed to uncover features of hepatitis-associated aplastic anemia
      and possibly reveal a common cause of the disease.

      Sample Collections

        -  Blood- will be collected at the time of the patient s initial evaluation or upon
           enrollment into the study and possibly periodically during the study. Blood will be
           drawn through a needle in an arm vein.

        -  Bone marrow- may be collected as part of the patient s standard medical care or
           specifically for research purposes of this study. For this procedure, the skin over the
           hipbone and the outer surface of the bone itself are numbed with an injection of a local
           anesthesia. Then, a larger needle is inserted into the hipbone and marrow is drawn into
           a syringe. Marrow cells are suctioned two to six times during the 15-minute procedure.

        -  Stool- will be provided by the patient.

      Liver- tissue may be biopsied as part of the patient s general medical care or for NIH
      patients, as part of their enrollment in a treatment protocol.
    

Detailed description: 
      Our laboratory has a long-standing interest in viruses that affect the bone marrow,
      especially those causing bone marrow failure. One specific syndrome, hepatitis-associated
      aplastic anemia, suggests that the same agent is responsible for the severe and sometimes
      fulminate hepatitis as well as the profound bone marrow failure. This study is designed to
      collect clinical data, and samples from patients with hepatitis-associated aplastic anemia,
      in order to learn more about the clinical features of the disease, as well as to collect
      blood, liver, bone marrow and stool samples where possible for ongoing virological studies.
      For liver and bone marrow samples, material will only be obtained when the liver or bone
      marrow are biopsied for other medical indications, or during the removal of the liver at the
      time of transplantation. No additional risk to the patient should result from either
      procedure.
    

Observational model: Cohort
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        primary clinical
      
Keywords: Bone Marrow Failure; Seronegative Hepatitis; Fulminate Hepatitis; Hepatitis; Aplastic Anemia; Hepatitis Associated Aplastic Anemia