COOMBS-NEGATIVE SEVERE HEMOLYSIS ASSOCIATED WITH HEPATITIS-A

Mild anemia can occasionally be observed during viral hepatitis, but s evere hemolysis has previously only been reported in a few patients wi th glucose-6-phosphate dehydrogenase (G6PD) deficiency. We report a ca se 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 resp onsible for hemolysis were ruled out, Although tests for autoimmune he molytic anemia were negative the patient made a dramatic recovery afte r treatment with corticosteroids, suggesting an immune mediated mechan ism nonetheless.