Coombs-Negative Autoimmune Hemolytic Anemia Associated With Liver Cirrhosis Due to Hepatitis C Virus

Mikiko Okazaki, Takakazu Higuchi, Ryosuke Koyamada, Sadamu Okada, Yoshiyuki Fujita, Toyomi Kamesaki


An 83-year-old woman who had been treated for liver cirrhosis due to hepatitis C virus (HCV) had progressive thrombocytopenia and anemia. Coombs-negative autoimmune hemolytic anemia (AIHA) was diagnosed based on the findings of hemolysis and the increased number of the red blood cell-bound immunoglobulin G molecules. The increased level of the platelet-associated immunoglobulin G and refractoriness to platelet transfusions suggested involvement of autoimmune mechanism in the thrombocytopenia. Oral prednisolone was effective for AIHA and thrombocytopenia. Global derangement of the immune system associated with HCV was suggested. As increased serum bilirubin and lactate dehydrogenase levels are common laboratory findings in patients with chronic HCV liver diseases, it is likely that a considerable number of patients complicated with Coombs-negative AIHA, which is a medically treatable anemia, are left without being noticed.

J Hematol. 2015;4(2):171-173


Hepatitis C virus; Liver cirrhosis; Autoimmune hemolytic anemia; Coombs test

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