Hariz Anis, Hamdi Mohamed Salah, Boukhris Imen, Cherif Eya
Research Laboratory of Kidney Diseases (LR00SP01), Charles Nicolle Hospital, Tunis, Tunisia.
Internal Medicine B, Hopital Charles Nicolle, Tunis, Tunisia.
BMJ Case Rep. 2019 Jul 15;12(7):e229807. 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.
虽然自身免疫性溶血性贫血(AIHA)是血液系统恶性肿瘤中一种广为人知的副肿瘤综合征,但在实体瘤中的报道要少得多。我们在此报告一例61岁男性患者,其患有与胰腺癌相关的AIHA。检查排除了AIHA的感染性、自身免疫性和毒性病因。腹部CT显示胰腺尾部存在一个大小为70×37×36毫米的低密度浸润性肿块,符合胰腺肿瘤表现。对肝脏两个相关结节性病变的组织学检查显示为胰腺腺癌转移。患者开始使用皮质类固醇治疗,但血红蛋白水平未改善。随后开始姑息化疗;这使得血红蛋白水平显著改善,从而证实了我们的诊断。该病例说明了AIHA与胰腺癌之间罕见的关联。然而,在排除其他更常见的病因之前,不能认定存在这种关联。