Hepatocellular carcinoma with chronic B-type hepatitis complicated by autoimmune hemolytic anemia: A case report

Table 1 Blood test data

AST	67 U/L	WBC	2700 × 106/L
ALT	64 U/L	RBC	199 × 1010/L
LDH	318 U/L	Reticulocyte	14.5%
(LDH1: 36.1%, LDH2: 34.2%)		HGB	7.9 g/dL
T. Bil	1.8 mg/dL	HCT	23.6%
(D.Bil: 0.9 mg/dL, I.Bil: 0.9 mg/dL)		MCV	130 fL
TP	6.2 g/dL	PLT	6 × 109/L
Alb	3.8 g/dL	PT%	68%
ICGR15	13%	HBsAg	69 COI
AFP	869 ng/mL	HBsAb	172 COI
PIVKA-II	301 AU/mL	HBeAg	108 COI
Direct Coombs test	Positive	HBeAB	40 Inh%
Anti-nuclear antibody	Negative	HBcAb	100 Inh%
HAM test	Negative	HBV-DNA PCR	5.9 LGE/mL
Sugar water test	Negative	TPHA	Negative
Cold agglutinin titer	256 times	HCVAb	Negative

Table 2 Cases of AIHA complications

Complicated disease	Number of complications by AIHA
A-type hepatitis	1
B-type hepatitis	2
C-type hepatitis	11
Autoimmune hepatitis	14
CMV hepatitis	1
Renal cell carcinoma	1a
Benign ovarian tumor	19b
HCC	2c

In patients with renal cell carcinoma (a) and ovarian tumor (b), AIHA improved after resection of them. In two cases of HCC complicated by AIHA (c), one is our case and the other is a case that revealed the symptom of AIHA after TAE for HCC.