title: Acute cholestatic hepatitis a virus infection presenting with hemolytic anemia and renal failure: a case report.
abstract: Hepatitis A virus is the most common acute viral hepatitis worldwide with approximately 1.5 million cases annually. Hepatitis A virus infection in general is self-limited. In rare cases, hepatitis A virus infection may cause renal failure, hemolytic anemia, and/or cholestasis. We report the first case of acute cholestatic hepatitis A virus infection complicated by hemolytic anemia, and renal failure in one patient. A 42-year-old Caucasian male presented with cholestasis, hemolytic anemia and renal failure after consuming street tacos in Central and South America while on a business trip. His protracted course required corticosteroid therapy, multiple sessions of plasma exchange, and numerous units of packed red blood cells. This case demonstrates the importance of vaccination in high-risk adults. A prompt diagnosis of acute hepatitis A virus infection is essential, as uncommon presentations may delay diagnosis leading to permanent morbidity and potentially death in fulminant cases. We also demonstrate the efficacy of treatment of cholestatic hepatitis A virus infection, hemolytic anemia, and renal failure with corticosteroids and plasma exchange.
authors.affiliation: University of Nebraska Medical Center, 982000 NMC, Omaha, NE 68198, USA.
authors.forename: Robert T
authors.identifier: 0000-0001-9847-6530
authors.initials: RT
authors.lastname: Lapp
authors.affiliation: University of Nebraska Medical Center, 982000 NMC, Omaha, NE 68198, USA.
authors.forename: Fedja
authors.initials: F
authors.lastname: Rochling