Science and Education Publishing American Journal of Medical Case Reports 2374-216X 3 6 2015 05 15 Severe Hemolysis as the First Manifestation of Acute Hepatitis A in an Adult with G6PD Deficiency and Positive ANA 158 159 EN Dhrubajyoti Bandyopadhyay Department of accident and emergency, Lady Hardinge Medical College, New Delhi Adrija Hajra Sabyasachi Mukhopadhyay Vijayan Ganesan Manas layek Debarati Bhar Diptak Bhowmick Cankatika choudhury Partha Sarathi Karmakar AJMCR2015362 10.12691/ajmcr-3-6-2 2015 04 22 2015 05 14 2015 05 15 We report a case of hemolytic anemia as an initial manifestation of hepatitis A virus infection. On admission, the patient had anemia, reticulocytosis, and direct and indirect hyperbilirubinemia. On subsequent examination, he had both glucose-6-phosphate dehydrogenase deficiency (G6PD) and autoimmune antibodies.