Acute Anaemia: A Challenging Diagnosis

  • Rui Costa Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Catarina Araújo Faria Internal Medicine Department, Hospital São Francisco Xavier, Lisbon, Portugal
  • Catarina Sofia Nunes Transfusion Medicine Department, Hospital São Francisco Xavier, Lisboa, Portugal
  • Filipa Ferreira Oncology Department, Hospital São Francisco Xavier, Lisboa, Portugal
  • Rui Cunha Intensive Care Medicine Department, Hospital São Francisco Xavier, Lisboa, Portugal
  • Inês Egídio Sousa Internal Medicine Department, Hospital São Francisco Xavier, Lisboa, Portugal
  • Inês Ferreira Internal Medicine Department, Hospital São Francisco Xavier, Lisboa, Portugal

Keywords

Acute anaemia, paraneoplastic syndrome, schistocytes, thrombotic microangiopathies

Abstract

Acute anaemia is characterized by a reduction in the number of red blood cells, haemoglobin levels or haematocrit. By far the most common aetiology is haemorrhage, but in its absence other less frequent causes should be considered.
The authors present the case of a 42-year-old man with a diagnosis of glucose-6-phosphate deficiency and progressing gastric signet ring cell carcinoma, who was admitted to the internal medicine department for symptomatic back pain control. During his hospitalization, the patient developed acute anaemia with schistocytes on peripheral blood smear with no concurrent hyperbilirubinaemia or decreased haptoglobin. Bone metastatic disease was documented. The case was revised with the transfusion medicine department and malignancy-associated microangiopathic haemolytic anaemia (Ma-MAHA) was suggested. The patient was transferred to the oncology department and later discharged, dying at home shortly afterwards.

References

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  • Lechner K, Obermeier HL. Cancer-related microangiopathic hemolytic anemia: clinical and laboratory features in 168 reported cases. Medicine 2012;91:195–205.

  • Shin SY, Park H, Wan Chae S, Woo HY. Microangiopathic hemolytic anemia as the first manifestation of metastatic signet ring cell carcinoma of unknown origin: a case report and review of literature. Korean J Lab Med 2011;31:157–161.
  • Published: 2018-09-18

    Issue: Vol 5 No 9 (view)

    Section: Articles

    How to cite:
    Costa, R., Faria, C., Nunes, C., Ferreira, F., Cunha, R., Sousa, I., & Ferreira, I. (2018). Acute Anaemia: A Challenging Diagnosis. European Journal of Case Reports in Internal Medicine, 5(9). https://doi.org/https://doi.org/10.12890/2018_000956

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