Autoimmune Hemolytic Anemia due to Varicella Infection

Varicella is usually benign exanthematous disease, which primarily affects children. The common complications are bacterial infection of skin eruptions, pneumonia, cerebellar ataxia, hepatitis, thrombocytopenia and arthritis[1]. Autoimmune hemolytic anemia (AIHA) is a rare complication of varicella and only few cases are reported[2-5]. Overall the incidence of AIHA in children is as low as 0.2/100,000 population[3]. We report AIHA due to chickenpox in a child who responded to steroids. An 11 year old female was brought with fever of one day followed by pleomorphic skin lesions of 8 days and jaundice of 2 days duration. Her urine and stools were normal. She was conscious, temperature was 37.8° C, HR 160/min, RR 32/min, BP of 90/60 mmHg and SpO2 was 90% in room air. On examination, she had severe pallor and jaundice. There were multiple vesicular and scabbed skin lesions of chicken pox all over the body. There was no evidence of bleeding tendencies, bony tenderness or lymphadenopathy. Abdominal examination revealed 3 cm hepatomegaly and 1 cm splenomegaly. The rest of the examination was unremarkable.