Tauseef Abubakar, Asghar Muhammad Sohaib, Zafar Maryam, Ahmed Iftekhar, Dawood Mustafa, Shaikh Tooba, Khan Narmin, Alam Tanveer
Resident Physician in Internal Medicine Department, Dow University Hospital, Karachi, Pakistan.
Greater Baltimore Medical Centre, MD, USA.
J Community Hosp Intern Med Perspect. 2019 Dec 14;9(6):499-502. doi: 10.1080/20009666.2019.1698262. eCollection 2019.
A 45-year-old Asian woman was presented with fever, easy fatigability, shortness of breath, cervical and axillary lymphadenopathy and other signs and symptoms of anemia. After all the baseline work-up, the patient was investigated for Mono-coombs C3d levels, which were elevated, suggesting the diagnosis of Cold autoimmune hemolytic anemia (Cold AIHA). An Ultrasound-guided true-cut biopsy was done to determine the primary cause associated with it, which showed the presence of tumor cells arranged in cords and clusters. They have dark staining cells with mitotic activity, suggestive of breast carcinoma as an association of Cold AIHA. Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) were sent, which came out to be positive. So, the patient was diagnosed with Cold AIHA in association with triple-positive breast cancer.
一名45岁的亚洲女性出现发热、易疲劳、气短、颈部和腋窝淋巴结肿大以及其他贫血症状。在完成所有基线检查后，对患者进行了单克隆库姆斯C3d水平检测，结果升高，提示诊断为冷凝集素自身免疫性溶血性贫血（冷凝集素AIHA）。进行了超声引导下的真实切割活检以确定与之相关的主要病因，结果显示存在呈条索状和团块状排列的肿瘤细胞。这些细胞染色深且有有丝分裂活性，提示乳腺癌与冷凝集素AIHA有关。送检了雌激素受体（ER）、孕激素受体（PR）和人表皮生长因子受体2（HER2），结果均为阳性。因此，该患者被诊断为冷凝集素AIHA合并三阳性乳腺癌。
