Severe Autoimmune Hemolytic Anemia Complicating Treatment-naive
Chronic Hepatitis C Infection: A Case Report

Mahadev      Meena; Durga   Shankar   Meena; Deepak      Kumar; Sonu      Pandit

Abstract

Background: Haematological manifestations in Hepatitis C virus (HCV) infection have been uncommon since the advent of direct-acting antiviral drugs (DAAs). However, primary HCV infection can cause significant haematological disease in the form of various autoimmune cytopenias.

Case Presentation: We herein discuss a 68-years-old female with chronic HCV infection for the last 15 years (not on the treatment), who presented with complaints of progressive fatigue, exertional dyspnea, and increased abdominal distention over the previous 20 days. Coombs-positive autoimmune haemolytic anaemia (AIHA) was diagnosed based on the haematological evaluation (raised lactate dehydrogenase, indirect bilirubinemia, raised reticulocyte count and direct Coombs positive). The patient showed significant improvement in haematological indices with oral prednisolone. However, she eventually succumbed to her illness due to underlying decompensated liver disease. HCV infection may associate with global derangement of the immune system, which is likely to cause AIHA. Diagnosis of autoimmune cytopenias can be easily missed in HCV positive patients due to underlying decompensated liver disease and portal hypertension.

Conclusion: Thus, screening of HCV infection is imperative in every patient of AIHA, especially with the high worldwide prevalence of HCV.

Keywords: Hepatitis C, liver, hemolytic anemia, autoimmune, Coombs test, cirrhosis.

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DOI https://dx.doi.org/10.2174/1871529X22666220418105506	Print ISSN 1871-529X
Publisher Name Bentham Science Publisher	Online ISSN 2212-4063

Cardiovascular & Hematological Disorders-Drug Targets

Severe Autoimmune Hemolytic Anemia Complicating Treatment-naive Chronic Hepatitis C Infection: A Case Report

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