[Hemolytic anemia in association with viral hepatitis]

During 1968-1994, 48 patients who has a hemolytic anemia complicated with viral hepatitis were reported in Japan, 25 with acute hepatitis A, 10 with acute hepatitis B, 10 with some other viral hepatitis, and 3 with chronic hepatitis. It is suggested that there are four mechanisms that occur hemolysis in the patients with viral hepatitis. (1) In the individual who has predisposition to hemolytic anemia, viral infection accelerates the red cell destruction and hemolysis become obvious. (2) Directly, virus itself injures to the red cell membrane. (3) The serious liver failure and hypersplenism induce the hemolysis. (4) Autoimmune hemolytic anemia because of immunological abnormality caused by viral infection. In this review, the clinical characteristics of hemolytic anemia in association with viral hepatitis were reviewed.