Coombs-Negative Haemolytic Anaemia, Direct Hyperbilirubinaemia and Splenomegaly: A Rare Amalgam

  • Radhika Kulkarni UCONN Health, Farmington, CT, USA
  • Amjad Basheer UCONN Health, Farmington, CT, USA
  • Aziz Khan UCONN Health, Farmington, CT, USA

Keywords

Herpesvirus 4, direct Coombs test, cholestasis, splenomegaly

Abstract

Introduction: Epstein-Barr virus (EBV) is notorious for its varied presentation in adults. Reactivation of EBV can occur at any time and is often due to weakened cellular immunity. 

Case Description: Here we report the case of a young woman with no previous medical history who presented with cholestatic hepatitis, Coombs-negative haemolytic anaemia and splenomegaly. Due to the initial disjointed picture with no other localizing symptoms, she underwent extensive work-up for the same.

Discussion: EBV has been associated with many malignancies, autoimmune diseases and chronic fatigue syndrome. EBV causes elevated liver enzymes; however, cholestatic hepatitis is exceedingly rare, with only a few cases reported. Haemolytic anaemia is a common complication of EBV infection and is often Coombs positive.

Conclusion: EBV testing should be considered before more invasive and expensive work-up in a patient presenting with multi-systemic abnormalities.

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  • Published: 2021-04-08

    Issue: LATEST ONLINE (view)

    Section: Articles

    How to cite:
    1.
    Kulkarni R, Basheer A, Khan A. Coombs-Negative Haemolytic Anaemia, Direct Hyperbilirubinaemia and Splenomegaly: A Rare Amalgam. EJCRIM 2021;2 doi:10.12890/2021_002477.