Sachin Yende, MB, BS; Dan Lancaster, MD
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Yende S, Lancaster D. Hepatitis A: A Potentially Serious Disease. Ann Intern Med. 1998;129:506-507. doi: 10.7326/0003-4819-129-6-199809150-00019
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Published: Ann Intern Med. 1998;129(6):506-507.
TO THE EDITOR:
We read with interest Willner and colleagues' report  on the recent hepatitis A epidemic in Tennessee, particularly the incidence of autoimmune hepatitis associated with hepatitis A. We report an unusual association of hepatitis A and immune thrombocytopenic purpura (ITP) seen during the epidemic reported by the authors.
An 18-year-old man presented with a 3-day history of abdominal pain, nausea, vomiting, subjective fever, and dark urine. He had been healthy and had no history of recent travel, tick exposure, or respiratory illness. He denied taking any medications and had no history of alcohol, tobacco, or drug abuse. On physical examination, the patient was hemodynamically stable. He had icteric sclerae, bleeding gums, and purpura over his chest and extremities. Abdominal examination showed tenderness in the epigastrium without distention, guarding, or rigidity. The liver was palpable 2 cm below the right costal margin, and there was no evidence of splenomegaly.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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