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KMID : 1103920110170040323
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Korean Journal of Hepatology
2011 Volume.17 No. 4 p.323 ~ p.327
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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
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Kim Hee-Sup
Jeong Sook-Hyang
Jang Je-Hyuck
Myung Hyung-Joon
Kim Jin-Wook
Bang Soo-Mee
Song Sang-Hoon
Kim Hae-Ryoung
Yun Hae-Sun
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Abstract
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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.
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KEYWORD
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Hepatitis A virus, Genotype, Coinfection, Hemolytic anemia, Korea
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