Case Reports in Hepatology

Case Report

Acute Hepatitis A Causing Severe Hemolysis and Renal Failure in Undiagnosed Glucose-6-Phosphate Dehydrogenase Deficient Patient: A Case Report and Review of the Literature

Table 1

Summary of reported cases with concomitant viral hepatitis and G6PD deficiency causing severe hemolysis.
YearAuthorNumber of casesAge (y)SexPresenting symptomsGeographic regionCause of viral hepatitisPresence of renal failureTreatmentNeed for transplantOutcome
1966Salen [23]338, 28, 39F, M, MFever, anorexia, and dark urineUSADid not specifyYes (1 patient)F: peritoneal dialysis, prednisone 40 mg qday; M-28: IVF; M-39: IVF and blood transfusionNoFull recovery
1969Clearfield et al. [4]329, 31, 24M, M, MMyalgia, nausea, pruritis, dark urine, and jaundiceUSADid not specifyNoSupportive care for all three patientsNoFull recovery
1975Chan and Todd [3]18N/AN/AFever and jaundiceHong KongDid not specifyNoSupportive care for all 18 patientsNo15 had full recovery and 3 died from renal failure and hemolysis
1985Agarwal et al. [24]59, 19, 10, 10, 85 MFever, jaundice, and vomitingIndiaDid not specifyYes (2 patients)4 patients required blood transfusions and 1 patient required peritoneal dialysis, blood transfusions, and antibioticsNo4 had full recovery and 1 died of liver and renal failure
2001Gotsman Muszkat [5]18Average 15.113 M, 5 FFever and jaundiceIsraelANo3 patients required blood transfusion, IVF fluids, and antibiotics. 15 patients required supportive careNoFull recovery
2002Abid and Khan [25]526,16, 14, 22, 355 MFatigue, fever, jaundice, and vomitingPakistanEYes (5 patients)Supportive care for all 5 patients and 2 patients required hemodialysisNoFull recovery
2003Monga et al. [26]135MFever, abdominal pain, fatigue, jaundice, and dark urineIndiaENoSupportive careNoFull recovery
2008Ozbay Hosnut et al. [8]210, 5M, FJaundice, emesis, and abdominal painEuropeAYes (1 patient)Male: IVF, blood transfusion, and plasmapheresis; female: antibiotic therapy, vitamin K, lactulose, IVF, and blood transfusionNoFull recovery
2009Thapa et al. [27]17MJaundiceIndiaENoSupportive careNoFull recovery
2011Somani et al. [29]117MFever, abdominal pain, anorexia, jaundice, and dark urineIndiaEYesSupportive careNoFull recovery
2011Au et al. [28]154MJaundice, cyanosis, and confusionHong KongEYesHemodialysisNoDied of cerebral hemorrhage
2012Jain et al [6]10Average 16.18 M, 2 FN/AIndiaA, ENoSupportive careNoFull recovery
2012Wing-Yan and Chan [34]253, 54MRight upper quadrant pain and flu-like symptomsHong KongEYes (1 patient)Blood transfusion and hemodialysisNo53-year-old died of seizures and sepsis. 54-year-old died of renal and liver failure
2014Tomar et al. [31]115MFever, jaundice, dark urine, nausea, fatigue, and decreased PO intakeIndiaEYesBlood transfusion and hemodialysisNoFull recovery
2015Dea [30]120MFever, jaundice, and dark urineIndiaANoSupportive careNoFull recovery
2016Karki et al. [32]148MJaundice, dark urine, fever, and confusionIndiaEYesBlood transfusion, hemodialysis, and antibioticsNoFull recovery
2017Moiz and Ali [7]110FFever, abdominal pain, and lethargyPakistanANoSupportive careNoFull recovery
2017Ahmad et al. [33]128MJaundice and abdominal painPakistanEYesBlood transfusion and hemodialysisNoFull recovery
2018Sharma et al. [9]139MFever, jaundice, and dark urineIndiaAYesBlood transfusion and intermittent hemodialysisNoFull recovery
2019Bajpai et al. [2]116MFever, jaundice, and dark urineIndiaAYesIVF, ventilation, antibiotics, continuous renal replacement, and plasma and blood transfusionNoFull recovery
2020Kamani et al. [35]219, 152 MJaundice, nausea, and vomitingPakistanENoIVF and blood transfusionNo19-year-old died from liver failure. 15-year-old made a full recovery
2020Abutineh et al. (present case)155MFatigue, fever, malaise, jaundice, and abdominal painUSAYesIVF, antibiotics, blood transfusion, and hemodialysisNoFull recovery