title: Coombs-negative severe hemolysis associated with hepatitis A.
abstract: Mild anemia can occasionally be observed during viral hepatitis, but severe hemolysis has previously only been reported in a few patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report a case of massive acute hemolysis associated with an acute hepatitis A in a 39-year-old woman in the absence of G6PD-deficiency. The patient was also suffering from mild rheumatoid arthritis. All known factors responsible for hemolysis were ruled out. Although tests for autoimmune hemolytic anemia were negative the patient made a dramatic recovery after treatment with corticosteroids, suggesting an immune mediated mechanism nonetheless.
authors.affiliation: I. Department of Medicine, Johannes Gutenberg University, Mainz, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ibe
authors.forename: B
authors.initials: B
authors.lastname: Rüde
authors.forename: G
authors.initials: G
authors.lastname: Gerken
authors.forename: K H
authors.initials: KH
authors.lastname: Meyer zum Büschenfelde
authors.forename: A W
authors.initials: AW
authors.lastname: Lohse
mesh_terms: D000328:Adult; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001323:Autoantibodies / Q000097:blood; D003298:Coombs Test; D005260:Female; D006506:Hepatitis A / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D008111:Liver Function Tests; D011239:Prednisolone / Q000008:administration & dosage
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D011239:Prednisolone