Hemolytic anemia following postnatally acquired rubella during the 1975-1977 rubella epidemic in Japan.

Hemolytic anemia following postnatally acquired rubella first was reported by Sato et al. in 1977. Thirteen cases of hemolytic anemia (including two cases of hemolytic uremic syndrome) following postnatally acquired rubella infection reported in a nationwide epidemic of rubella in Japan in 1975-1977 are reviewed in this article, and another case is added. Clinical symptoms of hemolytic anemia occurred 2 to 6 days from the onset of rubella rash. Direct Coombs test was positive in three of the 11 cases tested, and the indirect test was positive in two of the 13 cases. Hemolytic anemia should be considered as a complication of postnatally acquired rubella, though to date, it has only been reported in Japan.