{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T18:57:22Z","timestamp":1781895442352,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T00:00:00Z","timestamp":1741996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hematology Reports"],"abstract":"<jats:p>Aplastic anemia occurs with an incidence of 2\u20135: 1 million people worldwide. However, the frequency of newly diagnosed cases of bone marrow aplasia is greater, and some of these patients present to emergency departments initially. Description of Case: We present the case of a middle-aged man with pancytopenia. In this case, aplastic anemia associated with hepatitis B and syphilis was only the initial diagnosis. An indolent hematologic malignancy\u2014hairy cell leukemia\u2014was diagnosed as the real cause of the bone marrow failure in a clinic of hematology. Conclusions: This clinical case allows us to make a conclusion, albeit not definitively, about the contribution of hepatitis B and syphilis to the clinical manifestation of hairy cell leukemia. A detailed and consistent diagnostic plan is also required in patients presenting with pancytopenia. Failure to diagnose a hepatitis B infection in a patient with malignant hematologic disease would lead to fatal therapeutic errors.<\/jats:p>","DOI":"10.3390\/hematolrep17020013","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T04:29:28Z","timestamp":1742185768000},"page":"13","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Hairy Cell Leukemia: A Differential Diagnosis of Hepatitis B-Associated Aplastic Anemia and Syphilis"],"prefix":"10.3390","volume":"17","author":[{"given":"I.","family":"Kindekov","sequence":"first","affiliation":[{"name":"Clinic of Hematology, Military Hospital, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2426-6589","authenticated-orcid":false,"given":"E.","family":"Beleva","sequence":"additional","affiliation":[{"name":"Clinic of Hematology, Military Hospital, 1606 Sofia, Bulgaria"},{"name":"QSAR and Molecular Modelling, Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, 1784 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kadish","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine, Hepatology and Gastroenterology, University Hospital \u2018SOFIAMED\u2019, 1797 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ionchev","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine, University Hospital of Emergency Medicine \u2018Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1878-9807","authenticated-orcid":false,"given":"N.","family":"Semerdzhieva","sequence":"additional","affiliation":[{"name":"Clinic of Internal Medicine, University Hospital of Emergency Medicine \u2018Pirogov\u2019, 1606 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,15]]},"reference":[{"key":"ref_1","unstructured":"Litchman, M., Prchal, J., Levi, M., Burns, L.J., and Linch, D. 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