Warm Antibody Autoimmune Haemolytic Anaemia Associated with Ovarian Teratoma

Raimundo, P; Coelho, S; Cabeleira, A; Dias, L; Gonçalves, M

http://hdl.handle.net/10400.17/2241

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Abstract(s)

The ovarian cystic teratoma is a rare cause of autoimmune haemolytic anaemia by warm antibodies, resistant to corticotherapy, with few case reports published in the medical literature. We present a case of a 45-year-old woman admitted to hospital due to general weakness. Laboratory studies revealed macrocytic anaemia, biochemical parameters of haemolysis and peripheral spherocytosis. The direct Coombs test was positive. Viral serologies, anti-nuclear antibodies, anti-double-stranded DNA antibodies and β2-microglobulin were negative. CT scan of the thorax, abdomen and pelvis showed a heterogeneous right anexial lesion. The patient was treated with corticotherapy without improvement of anaemia. Regression of extra-vascular haemolysis and normalisation of haemoglobin was obtained only after laparoscopic splenectomy and right ooforectomy, and the histopathology of the right anexial mass revealed a cystic teratoma. Previously published cases controlled the haemolysis by surgically removing the lesion associated with splenectomy.

Keywords

HSJ MED HSJ ANPAT HSJ CIR Anemia, Hemolytic, Autoimmune/immunology Coombs Test Diagnosis, Differential Laparoscopy Ovarian Neoplasms/diagnosis Ovarian Neoplasms/immunology Ovarian Neoplasms/surgery Ovariectomy Splenectomy Teratoma/diagnosis Teratoma/immunology Teratoma/surgery Tomography, X-Ray Computed