Coinfection of hepatitis A virus genotype IA and IIIA complicated with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive immunoglobulin M anti-hepatitis E virus: a case report.
10.3350/kjhep.2011.17.4.323
- Author:
Hee Sup KIM
1
;
Sook Hyang JEONG
;
Je Hyuck JANG
;
Hyung Joon MYUNG
;
Jin Wook KIM
;
Soo Mee BANG
;
Sang Hoon SONG
;
Haeryoung KIM
;
Hae Sun YUN
Author Information
1. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. jsh@snubh.org
- Publication Type:Case Reports
- Keywords:
Hepatitis A virus;
Genotype;
Coinfection;
Hemolytic anemia;
Korea
- MeSH:
Adult;
Anemia, Hemolytic, Autoimmune/*diagnosis/drug therapy/etiology;
Anti-Inflammatory Agents/therapeutic use;
Cholestasis/*diagnosis/drug therapy/pathology;
Coinfection/*diagnosis;
Genotype;
Hepatitis A/complications/*diagnosis/genetics;
Hepatitis E/complications/*diagnosis/genetics;
Humans;
Immunoglobulin M/blood;
Liver/pathology/virology;
Male;
Prednisolone/therapeutic use;
RNA, Viral/blood
- From:The Korean Journal of Hepatology
2011;17(4):323-327
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 37-year-old male presented with fever and jaundice was diagnosed as hepatitis A complicated with progressive cholestasis and severe autoimmune hemolytic anemia. He was treated with high-dose prednisolone (1.5 mg/kg), and eventually recovered. His initial serum contained genotype IA hepatitis A virus (HAV), which was subsequently replaced by genotype IIIA HAV. Moreover, at the time of development of hemolytic anemia, he became positive for immunoglobulin M (IgM) anti-hepatitis E virus (HEV). We detected HAV antigens in the liver biopsy specimen, while we detected neither HEV antigen in the liver nor HEV RNA in his serum. This is the first report of hepatitis A coinfected with two different genotypes manifesting with autoimmune hemolytic anemia, prolonged cholestasis, and false-positive IgM anti-HEV.
