Isolated hemolytic anemia: an unusual manifestation of occult malignancy

Hemolysis is an uncommon and usually late complication of malignancy, and very rarely the presenting feature. Cancer-associated hemolysis may be immune-mediated, or may result from thrombotic microangiopathy accompanied by thrombocytopenia. We describe an unusual case of isolated hemolysis in the se...

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Bibliographic Details
Published inHematology reports Vol. 6; no. 1; p. 5159
Main Authors Butler, Matthew J, Yin, Ming, Quddus, Fahd
Format Journal Article
LanguageEnglish
Italian
Published Italy MDPI AG 05.02.2014
PAGEPress Publications
PAGEPress Publications, Pavia, Italy
Subjects
Adenocarcinoma
Anemia
Aromatase
Bone marrow
Breast cancer
Case Report
Chemotherapy
Corticosteroids
Cytotoxicity
Hemolysis
hemolysis, hemolytic anemia, malignancy, cancer
Hemolytic anemia
Malignancy
Metastases
Metastasis
Thrombocytopenia
Thrombotic microangiopathy
cancer
malignancy
hemolysis
hemolytic anemia
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Summary:Hemolysis is an uncommon and usually late complication of malignancy, and very rarely the presenting feature. Cancer-associated hemolysis may be immune-mediated, or may result from thrombotic microangiopathy accompanied by thrombocytopenia. We describe an unusual case of isolated hemolysis in the setting of occult metastatic breast cancer. The patient initially presented with symptomatic anemia, with evidence of hemolysis but with negative direct antiglobulin testing and a normal platelet count. Subsequent investigation discovered metastatic adenocarcinoma of the breast involving bone marrow. Hemolysis worsened despite initial treatment with cytotoxic chemotherapy and a trial of corticosteroids, but later resolved with aromatase inhibitor therapy.
Bibliography:Contributions: the authors contributed equally.
Conflict of interests: the authors declare no potential conflict of interests.
ISSN:2038-8322
2038-8330
2038-8330
DOI:10.4081/hr.2014.5159