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BMJ Case Rep. 2010; 2010: bcr06.2009.1971.
Published online 2010 May 19. doi:  10.1136/bcr.06.2009.1971
PMCID: PMC3052837
Rare disease

Warm antibody autoimmune haemolytic anaemia associated with ovarian teratoma

Abstract

The ovarian cystic teratoma is a rare cause of autoimmune haemolytic anaemia by warm antibodies, resistant to corticotherapy, with few case reports published in the medical literature.

We present a case of a 45-year-old woman admitted to hospital due to general weakness. Laboratory studies revealed macrocytic anaemia, biochemical parameters of haemolysis and peripheral spherocytosis. The direct Coombs test was positive. Viral serologies, anti-nuclear antibodies, anti-double-stranded DNA antibodies and β2-microglobulin were negative. CT scan of the thorax, abdomen and pelvis showed a heterogeneous right anexial lesion. The patient was treated with corticotherapy without improvement of anaemia. Regression of extra-vascular haemolysis and normalisation of haemoglobin was obtained only after laparoscopic splenectomy and right ooforectomy, and the histopathology of the right anexial mass revealed a cystic teratoma.

Previously published cases controlled the haemolysis by surgically removing the lesion associated with splenectomy.


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