Hepatitis E with Intravascular Hemolysis in Beta Thalassemia Trait: A Rare Association or Coincidence.

Hepatitis E virus is one of the leading causes of acute viral hepatitis in India but usually manifests as a mild self-limiting illness. It is known that severe intravascular hemolysis can occur in the course of acute Viral Hepatitis E in association with a G6PD deficiency state. Thalassemias are known to cause extravascular hemolysis. The role of β thalassemia trait in hemolysis during acute hepatitis E infection is not known. In this report we describe a rare coexistence of severe intravascular hemolysis in a patient with hepatitis E infection and β Thalassemia trait with bilirubin going upto 85 mg/dl without any renal dysfunction or complication. It may point towards an etiological basis of hemolysis in Hepatitis E due to Thalassemia.