Chronic hepatitis C virus infection associated with primary warm-type autoimmune hemolytic anemia

Autoimmune hematologic abnormalities are not well recognized in chronic hep atitis C virus infection. We demonstrate an unusual association between pri mary autoimmune hemolytic anemia and chronic hepatitis C virus infection. A 69-year-old woman who had a history of hepatitis C virus-related liver cir rhosis was found to have deteriorating anemia with reticulocytosis when adm itted to the hospital. Laboratory work revealed both positive direct and in direct Coombs' tests, and warm-type immunoglobulin G against surface antige ns of red blood cells. After prednisolone therapy, her anemia improved dram atically. To our knowledge, this is the first reported case of chronic hepa titis C virus infection linked with autoimmune hemolytic anemia in its natu ral course, not related to prior interferon treatment. Our report suggests that isolated autoimmune hemolytic anemia may be one of the unusual hematol ogic manifestations of chronic hepatitis C virus infection.