# Case Report: Acute hepatitis A virus infection presenting with direct antiglobulin test-negative autoimmune hemolytic anemia and α-thalassemia trait

## TL;DR

This case report describes a rare instance of hepatitis A causing hemolytic anemia in a person with α-thalassemia trait.

## Contribution

The paper presents a rare case of Coombs-negative AIHA as the first sign of hepatitis A in an α-thalassemia carrier.

## Key findings

- Hepatitis A virus infection can present with Coombs-negative autoimmune hemolytic anemia.
- The patient was a silent carrier of α-thalassemia trait, adding complexity to the diagnosis.
- This case highlights the need for considering rare presentations of hepatitis A.

## Abstract

Reports from the literature have discussed patients presenting Hepatitis A virus infection with hemolytic anemia, specifically with glucose-6-phosphate dehydrogenase deficiency. However, autoimmune hemolytic anemia (AIHA) has been rarely reported. We present a challenging case of Coombs-negative hemolytic anemia as initial manifestation of hepatitis A virus infection in a silent carrier of α-thalassemia.