Author(s):
Raimundo, P ; Coelho, S ; Cabeleira, A ; Dias, L ; Gonçalves, M
Date: 2010
Persistent ID: http://hdl.handle.net/10400.17/2241
Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
Subject(s): HSJ MED; HSJ ANPAT; HSJ CIR; Anemia, Hemolytic, Autoimmune/immunology; Coombs Test; Diagnosis, Differential; Laparoscopy; Ovarian Neoplasms/diagnosis; Ovarian Neoplasms/immunology; Ovarian Neoplasms/surgery; Ovariectomy; Splenectomy; Teratoma/diagnosis; Teratoma/immunology; Teratoma/surgery; Tomography, X-Ray Computed
Description
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.
