Autoimmune haemolytic anaemia in pancreatic adenocarcinoma: a potential paraneoplastic presentation

• Published in: BMJ case reports Vol. 12; no. 7; p. e229807
• Main Authors: Hariz, Anis, Hamdi, Mohamed Salah, Boukhris, Imen, Cherif, Eya
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-07-2019; BMJ Publishing Group
• Series: Case Report
• Subjects: Abdomen; Adenocarcinoma - complications; Adenocarcinoma - drug therapy; Anemia; Anemia, Hemolytic, Autoimmune - etiology; Anticoagulants - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Autoimmune diseases; Blood; Case reports; Chemotherapy; Cysts; Dehydrogenases; Diabetes; Family medical history; Hematology; Hemoglobin; Heparin, Low-Molecular-Weight - therapeutic use; Hepatitis; Humans; Immunoglobulins; Laboratories; Male; Metastasis; Middle Aged; Ovarian cancer; Pancreatic cancer; Pancreatic Neoplasms - complications; Pancreatic Neoplasms - drug therapy; Paraneoplastic Syndromes - complications; Paraneoplastic Syndromes - drug therapy; Thrombosis; Treatment Outcome; Tumors; Unusual Association of Diseases/Symptoms; Veins & arteries; Venous Thrombosis - drug therapy; Venous Thrombosis - etiology; pancreatic cancer; haematology (incl blood transfusion); surgical oncology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2019-229807

While autoimmune haemolytic anaemia (AIHA) is a well-known paraneoplastic syndrome in haematological malignancies, it has been described far less in solid tumours. We hereby report the case of a 61-year-old male patient presenting AIHA related to pancreatic cancer. Investigations excluded infectious, autoimmune and toxic causes of AIHA. CT of the abdomen highlighted the presence of hypodense, infiltrating mass of the tail of the pancreas measuring 70×37×36 mm, compatible with pancreas neoplasm. Histological examination of two associated nodular lesions of the liver showed metastasis of pancreatic adenocarcinoma. The patient was started on corticosteroid without improvement of haemoglobin. Palliative chemotherapy was initiated; this led to significant improvement in haemoglobin comforting our diagnosis. This case illustrates the rare association between AIHA and pancreatic cancer. However, such association cannot be considered before excluding other, more frequent, aetiologies.