A 25-year-old female was admitted to a hospital with low grade fever and jaundice on Feb. 22, 1984. A diangosis of acute hepatitis type B was made from the biochemical findings of markedly elevated serum transaminase and positive HBsAg.
But she was referred to our hospital with hyperbililubinemia on March 13, and she developed severe anemia and reticulocytosis from 5th hospital day. A bone marrow aspirate showed hyperplasia of erythroblasts. The level of LDH increased and haptoglobin decreased, but Coombs test was negative. She was diagnosed as hemolytic anemia associated with viral hepatitis and responded excellently to the treatment with high dose prednisolone. Liver function improved thereafter and HBsAg turned to be negative.