Article Text

Rare disease
Warm antibody autoimmune haemolytic anaemia associated with ovarian teratoma
  1. Pedro Oliveira Raimundo1,
  2. Susana Coelho1,
  3. Alexandra Cabeleira2,
  4. Luis Dias1,
  5. Manuela Gonçalves3,
  6. Julio Almeida1
  1. 1Hospital Sao José, Serviço Medicina Interna 1.2, Rua José António Serrano, Lisboa, 1150-199, Portugal
  2. 2Hospital Sao José, Serviço Cirurgia Geral 1, Rua José António Serrano, Lisboa, 1150-199, Portugal
  3. 3Hospital Sao José, Serviço Anatomia Patológica, Rua José António Serrano, Lisboa, 1150-199, Portugal
  1. Correspondence to Susana Coelho, susana.c.coelho{at}gmail.com

Summary

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.

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Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.