SHM Converge Scientific Abstract ePoster Gallery-A Case of Autoimmune Hemolytic Anemia Triggered by Endometrial Cancer

Pdf Summary

This case report describes a rare instance of autoimmune hemolytic anemia (AIHA) triggered by endometrial carcinoma in a 55-year-old Korean woman. AIHA is an antibody-mediated destruction of red blood cells and is usually linked to hematologic malignancies, autoimmune disease, or infection, making a solid tumor cause unusual.<br /><br />The patient presented to the emergency department with abdominal pain and was found to have severe new-onset anemia. Laboratory testing showed hemoglobin of 4.2 g/dL, thrombocytosis, and an elevated reticulocyte count. A direct antiglobulin (Coombs) test was positive for warm autoantibodies, and peripheral smear findings supported spherocytic hemolytic anemia, confirming AIHA.<br /><br />Pelvic examination and MRI revealed a large multilobulated uterine mass with features initially resembling fibroids, including calcifications and a long-standing history of prior imaging showing a similar lesion. The mass was also causing left hydronephrosis by compressing the ureter. Biopsy later demonstrated endometrioid carcinoma. BRCA1/BRCA2 testing was negative, while CA-15-3 was markedly elevated and CA-125 remained normal.<br /><br />Treatment included total hysterectomy, tumor debulking, and omentectomy, along with glucocorticoid therapy (prednisone). Chemotherapy with paclitaxel and carboplatin was also administered. Although hemoglobin and reticulocyte counts initially normalized after surgery and steroids, anemia recurred when prednisone was stopped, suggesting only temporary control of the AIHA.<br /><br />The report emphasizes that clinicians should consider non-classical causes of AIHA, including uterine malignancies, particularly in East-Asian patients. It also highlights that while steroids are standard treatment, definitive management of tumor-associated AIHA may require removal of the underlying malignancy, though responses may be incomplete or transient.

Asset Subtitle

Maie M. Zagloul

Meta Tag

Author List Abhishek Janardan, Maie M. Zagloul

Category Clinical Vignettes

Concept Autoimmune Hemolytic Anemia

Concept Warm Autoantibody

Concept Direct Antiglobulin Test

Concept Anemia

Concept Corticosteroid

Distinguished Non-Finalist

Presenter Organization Medical College of Wisconsin

Presenting Author Maie M. Zagloul

Track Adult

Keywords

autoimmune hemolytic anemia

AIHA

endometrial carcinoma

uterine malignancy

warm autoantibodies

Coombs test

hemolytic anemia

prednisone

hysterectomy

paclitaxel carboplatin

Autoimmune Hemolytic Anemia

Warm Autoantibody

Direct Antiglobulin Test

Anemia

Corticosteroid