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Cardiovascular & Hematological Disorders-Drug Targets

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ISSN (Print): 1871-529X
ISSN (Online): 2212-4063

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Case Report

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

Author(s): Mahadev Meena, Durga Shankar Meena*, Deepak Kumar and Sonu Pandit

Volume 22, Issue 1, 2022

Published on: 27 April, 2022

Page: [6 - 9] Pages: 4

DOI: 10.2174/1871529X22666220418105506

Price: $65

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.

« Previous
[1]
Cacoub, P.; Comarmond, C.; Domont, F.; Savey, L.; Desbois, A.C.; Saadoun, D. Extrahepatic manifestations of chronic hepatitis C virus infection. Ther. Adv. Infect. Dis., 2016, 3(1), 3-14.
[http://dx.doi.org/10.1177/2049936115585942] [PMID: 26862398]
[2]
Kuna, L.; Jakab, J.; Smolic, R.; Wu, G.Y.; Smolic, M. HCV Extrahepatic Manifestations. J. Clin. Transl. Hepatol., 2019, 7(2), 172-182.
[PMID: 31293918]
[3]
Cacoub, P.; Saadoun, D. Extrahepatic Manifestations of chronic HCV infection. N. Engl. J. Med., 2021, 384(11), 1038-1052.
[http://dx.doi.org/10.1056/NEJMra2033539] [PMID: 33730456]
[4]
El-Serag, H.B.; Hampel, H.; Yeh, C.; Rabeneck, L. Extrahepatic manifestations of hepatitis C among United States male veterans. Hepatology, 2002, 36(6), 1439-1445.
[http://dx.doi.org/10.1002/hep.1840360621] [PMID: 12447870]
[5]
Ramos-Casals, M.; García-Carrasco, M.; López-Medrano, F.; Trejo, O.; Forns, X.; López-Guillermo, A.; Muñoz, C.; Ingelmo, M.; Font, J. Severe autoimmune cytopenias in treatment-naive hepatitis C virus infection: Clinical description of 35 cases. Medicine (Baltimore), 2003, 82(2), 87-96.
[http://dx.doi.org/10.1097/00005792-200303000-00003] [PMID: 12640185]
[6]
Basseri, R.J.; Schmidt, M.T.; Basseri, B. Autoimmune hemolytic anemia in treatment-naive chronic hepatitis C infection: A case report and review of literature. Clin. J. Gastroenterol., 2010, 3(5), 237-242.
[http://dx.doi.org/10.1007/s12328-010-0165-x] [PMID: 26190328]
[7]
Elhajj, I.I.; Sharara, A.I.; Taher, A.T. Chronic hepatitis C associated with Coombs-positive hemolytic anemia. Hematol. J., 2004, 5(4), 364-366.
[http://dx.doi.org/10.1038/sj.thj.6200400] [PMID: 15297855]
[8]
Fernández, A.B. An unusual case of autoimmune hemolytic anemia in treatment naïve hepatitis C virus infection. Hematology, 2006, 11(5), 385-387.
[http://dx.doi.org/10.1080/10245330600938596] [PMID: 17607592]
[9]
Ohsawa, I.; Uehara, Y.; Hashimoto, S.; Endo, M.; Fujita, T.; Ohi, H. Autoimmune hemolytic anemia occurred prior to evident nephropathy in a patient with chronic hepatitis C virus infection: Case report. BMC Nephrol., 2003, 29(4), 7.
[http://dx.doi.org/10.1186/1471-2369-4-7]
[10]
Dietvorst, M.H.; van Wijngaarden, P.; de Man, R.A. Autoimmune haemolytic anaemia due to chronic hepatitis C virus infection treated with prednisone, pegylated interferon and ribavirin. Neth. J. Med., 2009, 67(3), 109-110.
[PMID: 19307685]
[11]
Etienne, A.; Gayet, S.; Vidal, F.; Poullin, P.; Brunet, C.; Harlé, J.R.; Kaplanski, G. Severe hemolytic anemia due to cold agglutinin complicating untreated chronic hepatitis C: Efficacy and safety of anti-CD20 (rituximab) treatment. Am. J. Hematol., 2004, 75(4), 243-245.
[http://dx.doi.org/10.1002/ajh.20004] [PMID: 15054819]
[12]
Stasi, C.; Silvestri, C.; Voller, F. Update on hepatitis C epidemiology: Unaware and untreated infected population could be the key to elimination. SN Compr. Clin. Med., 2020, 2(12), 2808-2815.
[http://dx.doi.org/10.1007/s42399-020-00588-3] [PMID: 33103061]
[13]
Citarella, A.; Cammarota, S.; Bernardi, F.F.; Coppola, C.; D’Antò, M.; Fogliasecca, M.; Giusto, E.; Masarone, M.; Salomone Megna, A.; Sellitto, C.; Servodio, R.; Smaldone, M.; Staiano, L.; Trama, U.; Conti, V.; Persico, M. Screening, linkage to care and treatment of hepatitis C infection in primary care setting in the south of italy. Life (Basel), 2020, 10(12), 359.
[http://dx.doi.org/10.3390/life10120359] [PMID: 33352991]
[14]
Ferri, S.; Muratori, L.; Lenzi, M.; Granito, A.; Bianchi, F.B.; Vergani, D. HCV and autoimmunity. Curr. Pharm. Des., 2008, 14(17), 1678-1685.
[http://dx.doi.org/10.2174/138161208784746824] [PMID: 18673191]
[15]
Dimitroulis, D.; Valsami, S.; Stamopoulos, P.; Kouraklis, G. Immunological HCV-associated thrombocytopenia: Short review. Clin. Dev. Immunol., 2012, 2012, 378653.
[http://dx.doi.org/10.1155/2012/378653] [PMID: 22829850]
[16]
Giordano, N.; Amendola, A.; Papakostas, P.; Cipolli, F.; Agate, V.M.; Battisti, E.; Marchi, B.; Nuti, R. Immune and autoimmune disorders in HCV chronic liver disease: Personal experience and commentary on literature. New Microbiol., 2005, 28(4), 311-317.
[PMID: 16386015]
[17]
Al-Ansari, M.; Weilert, F.; Dickson, G. Interferon-induced haemolytic anaemia in hepatitis C. N. Z. Med. J., 2008, 121(1278), 78-81.

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