Severe Thrombocytopenia with Bleeding Secondary to Acute Viral Hepatitis A

We here report one unique pediatric case of a 6 year old girl who presented with fever, icterus and bleeding (gum bleed, generalized petechial rashes, hematuria) with severe thrombocytopenia (4 x 109/L) and was eventually diagnosed as a case of acute hepatitis A (HAV). Severe thrombocytopenia with bleeding is known to be associated with many infectious diseases but secondary to acute hepatitis A infection is rarely reported. In our case, thrombocytopenia resolved only after intravenous immunoglobin (IVIG) therapy. To the best of our knowledge, this is the fifth reported case in english literature of thrombocytopenia in pediatric age group associated with hepatitis A and the first case in which thrombocytopenia responded to IVIG after failure of 5 days of oral prednisolone.