Case Report

Immune Thrombocytopenic Purpura and Hemolytic Anemia Secondary to Hepatitis A


Hepatitis A is common in children and usually is a self-limiting disease.  Although extrahepatic and hematological immune manifestations following acute hepatitis A virus (HAV) infection have rarely been reported, they are frequently observed in other viral hepatitis. In this paper, we report the case of a 3-year-old girl who developed immune thrombocytopenic purpura (ITP) and hemolytic anemia after HAV infection. She was presented with malaise, pallor, ecchymosis, petechiae and purpura on the trunk and extremities.

Scott JX, Gnananayagam EJ, Gupta S, et al. Thrombocytopenic purpura as initial presentation of acute hepatitis A. Indian J Gastroenterol. 2003; 22: 192-3.

Shenoy R, Nair S, Kamath N. Thrombocytopenia in hepatitis A- an atypical presentation. J Trop Pediatr. 2004; 50 (4): 241-2.

Tibble JA, Ireland A, Duncan JR. Acute auto immune haemolyticanaemia secondary to hepatitis A infection. Clin Lab Haem. 1997; 19(1): 73-5.

Ertem D, Acar Y, Pehlivanoglu E. Autoimmune complications associated with hepatitis A virus infection in children. Pediatr Infect Dis J. 2001; 20(8): 809-11.

Akarsu S, Erensoy A, Elkıran Ö, et al. Hematological abnormalities in patients with acute viral hepatitis A and B. J Pediatr Inf. 2008; 3: 90-5.

Amarapurkar DN, Amarapurkar AD. Extrahepatic manifestations of viral hepatitis. Ann Hepatol. 2002; 1(4): 192-5.

Avci Z, Turul T, Catal F, et al. Thrombocytopenia and emperipolesis in a patient with hepatitis A infection. PediatrHematolOncol. 2002; 19(1): 67-70.

Samanta T, Das AK, Ganguly S. Profile of hepatitis A infection with atypical manifestations in children. Indian J Gastroenterol. 2010; 29(1): 37–9.

Tanir G, Aydemir C, Tuygun N, et al. Immune thrombocytopenic purpura as sole manifestation in a case of acute hepatitis A. Turk J Gastroentrol. 2005; 16(4): 217-9.

Leblebısatan G, Tümgör G, Saşmaz I, et al. Hepatitis A-associated immune thrombocytopenia. Turk J Gastroentrol. 2012; 23(2): 195-7.

IssueVol 11, No 2 (2017) QRcode
SectionCase Report(s)
Hepatitis A Immune thrombocytopenic purpura Hemolyticanemia

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Miri-Aliabad G, Rashidi S. Immune Thrombocytopenic Purpura and Hemolytic Anemia Secondary to Hepatitis A. Int J Hematol Oncol Stem Cell Res. 2017;11(2):89-91.