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Acute hemolysis associated with hepatitis A.

K Hara, K Tagawa, T Unuma

    Gastroenterologia Japonica
    |December 1, 1985
    PubMed
    Summary
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    Hepatitis A can cause acute hemolytic anemia, characterized by jaundice and low hemoglobin. Prednisolone treatment effectively resolved these symptoms, indicating hemolysis as a complication of hepatitis A.

    Area of Science:

    • Hepatology
    • Hematology
    • Infectious Diseases

    Background:

    • Acute hepatitis A infection can present with various complications.
    • Hemolytic anemia is a rare but serious complication associated with viral infections.

    Observation:

    • A 62-year-old woman with acute hepatitis A developed indirect hyperbilirubinemia, splenomegaly, and anemia with reticulocytosis.
    • Clinical and laboratory findings, including elevated plasma hemoglobin and LDH1, indicated hemolysis.
    • Bone marrow examination revealed erythroid hyperplasia, and the Coombs test was negative.

    Findings:

    • Prednisolone treatment (40 mg daily for 30 days) led to increased hemoglobin levels and decreased total bilirubin.
    • Liver biopsy confirmed the recovery stage of acute hepatitis.

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  • Red blood cell enzyme activities and morphology were normal one year post-onset, ruling out intrinsic red blood cell defects.

    • Implications:

    • This case highlights hemolytic anemia as a potential complication of acute hepatitis A.
    • Prompt diagnosis and management, including the use of corticosteroids, can effectively treat this complication.
    • Further research is warranted to understand the mechanisms linking hepatitis A and autoimmune hemolysis.