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A very rare case of acute hepatitis type B, complicated with severe hemolytic anemia, was reported. A 33-year old male was admitted with right hypochondralgia. Laboratory studies disclosed markedly elevated serum transaminase, positive HBsAg and IgM anti HBc, low titer in anti HBc, so we diagnosed acute hepatitis type B. He had a good clinical course with bed rest, but from 17th hospital day he developed high fever, splenomegaly and severe anemia. Laboratory examinations disclosed marked elevation of reticulocyte and LDH and marked depression of haptoglobin. The picture of bone marrow showed hyperplasia of erythrocyte series. We diagnosed hemolytic anemia and administered high dose predonisolone with marked effect. Liver function improved gradually, and HBsAg became negative. Laboratory examinations disclosed positive anti HBs and anti HBe at about four months after discharge. Some mechanisms of hemolysis were discussed.
社団法人日本肝臓学会の論文