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  • Title: Coombs-negative severe hemolysis associated with hepatitis A.
    Author: Ibe M, Rüde B, Gerken G, Meyer zum Büschenfelde KH, Lohse AW.
    Journal: Z Gastroenterol; 1997 Jul; 35(7):567-9. PubMed ID: 9273990.
    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.
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