A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma
An 80-year-old male presented with dyspnea on exertion for at least two months. He also complained of progressive dysphagia and weight loss of 35 pounds over the last eight months. Initial blood tests showed hemoglobin of 6.1 g/dl, reticulocytes count of 19.7%, total bilirubin of 3.2 mg/dl, lactate...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Case Reports in Oncological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/8414602 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562097752375296 |
|---|---|
| author | Kavita Agrawal Flores Alfonso |
| author_facet | Kavita Agrawal Flores Alfonso |
| author_sort | Kavita Agrawal |
| collection | DOAJ |
| description | An 80-year-old male presented with dyspnea on exertion for at least two months. He also complained of progressive dysphagia and weight loss of 35 pounds over the last eight months. Initial blood tests showed hemoglobin of 6.1 g/dl, reticulocytes count of 19.7%, total bilirubin of 3.2 mg/dl, lactate dehydrogenase of 600 U/L, and haptoglobin of less than 8 mg/dl, and direct Coombs test was positive for warm immunoglobulin G. The impression was autoimmune hemolytic anemia (AIHA). The evaluation of dysphagia with esophagogastroduodenoscopy revealed a single irregular 4 cm malignant appearing ulcerated mass at the incisura angularis of the stomach. The mass was confirmed as adenocarcinoma on biopsy. Diagnostic laparoscopy was positive for malignant cells and he was diagnosed with stage IV adenocarcinoma of the stomach. Other extensive workup to determine the etiology of AIHA was negative (described in detail below). Surgery was deferred primarily due to metastasis of cancer. Initially, hemoglobin was stabilized by intravenous methylprednisolone, high dose immunoglobulins, and packed red blood cell transfusions. After a few weeks, hemoglobin started trending down again. The patient was weaned off steroids and paradoxically IgG-mediated autohemolysis was controlled with the initiation of palliative chemotherapy. Our case highlights a rare occurrence of AIHA in association with gastric adenocarcinoma. |
| format | Article |
| id | doaj-art-1246e6f3c22b486986ed2cc8fcdda109 |
| institution | Kabale University |
| issn | 2090-6706 2090-6714 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Oncological Medicine |
| spelling | doaj-art-1246e6f3c22b486986ed2cc8fcdda1092025-02-03T01:23:22ZengWileyCase Reports in Oncological Medicine2090-67062090-67142017-01-01201710.1155/2017/84146028414602A Rare Association of Autoimmune Hemolytic Anemia with Gastric AdenocarcinomaKavita Agrawal0Flores Alfonso1Department of Internal Medicine, Overlook Medical Center, Summit, NJ 07901, USADepartment of Pathology, Overlook Medical Center, Summit, NJ 07901, USAAn 80-year-old male presented with dyspnea on exertion for at least two months. He also complained of progressive dysphagia and weight loss of 35 pounds over the last eight months. Initial blood tests showed hemoglobin of 6.1 g/dl, reticulocytes count of 19.7%, total bilirubin of 3.2 mg/dl, lactate dehydrogenase of 600 U/L, and haptoglobin of less than 8 mg/dl, and direct Coombs test was positive for warm immunoglobulin G. The impression was autoimmune hemolytic anemia (AIHA). The evaluation of dysphagia with esophagogastroduodenoscopy revealed a single irregular 4 cm malignant appearing ulcerated mass at the incisura angularis of the stomach. The mass was confirmed as adenocarcinoma on biopsy. Diagnostic laparoscopy was positive for malignant cells and he was diagnosed with stage IV adenocarcinoma of the stomach. Other extensive workup to determine the etiology of AIHA was negative (described in detail below). Surgery was deferred primarily due to metastasis of cancer. Initially, hemoglobin was stabilized by intravenous methylprednisolone, high dose immunoglobulins, and packed red blood cell transfusions. After a few weeks, hemoglobin started trending down again. The patient was weaned off steroids and paradoxically IgG-mediated autohemolysis was controlled with the initiation of palliative chemotherapy. Our case highlights a rare occurrence of AIHA in association with gastric adenocarcinoma.http://dx.doi.org/10.1155/2017/8414602 |
| spellingShingle | Kavita Agrawal Flores Alfonso A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma Case Reports in Oncological Medicine |
| title | A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma |
| title_full | A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma |
| title_fullStr | A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma |
| title_full_unstemmed | A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma |
| title_short | A Rare Association of Autoimmune Hemolytic Anemia with Gastric Adenocarcinoma |
| title_sort | rare association of autoimmune hemolytic anemia with gastric adenocarcinoma |
| url | http://dx.doi.org/10.1155/2017/8414602 |
| work_keys_str_mv | AT kavitaagrawal arareassociationofautoimmunehemolyticanemiawithgastricadenocarcinoma AT floresalfonso arareassociationofautoimmunehemolyticanemiawithgastricadenocarcinoma AT kavitaagrawal rareassociationofautoimmunehemolyticanemiawithgastricadenocarcinoma AT floresalfonso rareassociationofautoimmunehemolyticanemiawithgastricadenocarcinoma |