Hepatitis A virus infection associated with hemophagocytic syndrome: report of two cases.

Virus-associated hemophagocytic syndrome (VAHS) is reported to be a rare complication in hepatitis A virus infections. We encountered two patients with hepatitis A virus-associated hemophagocytic syndrome (HAV-AHS). Although hemophagocytosis associated with other types of virus infections is fatal, the present patients with HAV-AHS recovered well without any treatment. Thrombocytopenia is an initial important finding of VAHS which is not rare in patients with acute hepatitis A. If bone marrow aspiration is performed more frequently, more HAV-AHS will be diagnosed. Further investigations are necessary to clarify the clinical features of HAV-AHS in more patients.