隐匿性播散性转移性乳腺癌表现为获得性血栓性血小板减少性紫癜。
Occult Disseminated Metastatic Breast Carcinoma Presenting as Acquired Thrombotic Thrombocytopenic Purpura.
作者信息
Chong Siew Lian, Ahmad Asnawi Asral Wirda, Hamzah Roszymah, Liew Pek Kuen, Ong Tee Chuan, Tan Sen Mui, Chang Kian Meng
机构信息
Department of Hematology, Hospital Ampang, Ampang, Malaysia.
Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia.
出版信息
Case Rep Oncol. 2021 Dec 27;14(3):1814-1820. doi: 10.1159/000521159. eCollection 2021 Sep-Dec.
Cancer-related microangiopathic hemolytic anemia (MAHA) is a rare and life-threatening condition. We present a patient who had been treated for invasive lobular breast carcinoma in clinical remission with fever and hemolytic anemia. The peripheral blood film showed MAHA and thrombocytopenia, and a functional deficiency of ADAMTS13 activity of 23% consistent with acquired thrombotic thrombocytopenic purpura. Bone marrow aspirate and trephine biopsy confirmed metastatic carcinoma. Further evaluation revealed the involvement of multiple bone sites without recurrence of the primary tumor. The patient received a daily plasma exchange with cryosupernatant and was pulsed with corticosteroids. MAHA related to breast cancer appears to be a rare occurrence.
癌症相关的微血管病性溶血性贫血（MAHA）是一种罕见且危及生命的病症。我们报告了一名曾接受浸润性小叶乳腺癌治疗且处于临床缓解期的患者，该患者出现发热和溶血性贫血。外周血涂片显示存在MAHA和血小板减少，ADAMTS13活性功能性缺陷为23%，符合获得性血栓性血小板减少性紫癜。骨髓穿刺和活检证实为转移性癌。进一步评估显示多个骨部位受累，原发肿瘤未复发。该患者接受了每日一次的冷上清液血浆置换，并给予大剂量糖皮质激素冲击治疗。与乳腺癌相关的MAHA似乎较为罕见。
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