scholarly journals Colon Cancer: An Unusual Presentation with a Paraneoplastic Syndrome

2021 ◽  
Vol 4 (4) ◽  
pp. 341-343
Author(s):  
Reham Almasoud ◽  
Rasha Alloush ◽  
Labib Al-Ozaibi
Keyword(s):  
Hemolytic Anemia ◽  
Paraneoplastic Syndrome ◽  
Tumor Resection ◽  
Clinical Syndrome ◽  
Ascending Colon ◽  
Microangiopathic Hemolytic Anemia ◽  
Underlying Malignancy ◽  
Paraneoplastic Disorder ◽  
Late Stages ◽  
Proximal Myopathy

Dermatomyositis (DM) is a rheumatological disorder characterized by proximal myositis and distinctive dermatological manifestations. It can be an isolated clinical syndrome or, in rarer cases, can be the initial presentation for an underlying malignancy as a part of a paraneoplastic syndrome. In this case report, we describe a case of a 51-year-old lady who presented with proximal myopathy, typical DM skin rash, dysphagia, and markedly elevated creatine kinase. She was diagnosed with a seronegative DM and her malignancy screening revealed a mass in the ascending colon. During her hospital course, she also developed microangiopathic hemolytic anemia, another paraneoplastic disorder typically associated with late stages of malignancy, manifested as hemolytic anemia, thrombocytopenia, and low fibrinogen. The patient received intravenous corticosteroids and underwent tumor resection with following resolution of her both rheumatological and hematological manifestation. Unfortunately, due to her general poor health, she developed sepsis and died in the hospital.

scholarly journals How I Treat Microangiopathic Hemolytic Anemia in Patients with Cancer

Blood ◽  
2021 ◽  
Author(s):  
Mari Thomas ◽  
Marie Scully
Keyword(s):  
Hemolytic Anemia ◽  
Thrombus Formation ◽  
Bone Marrow Involvement ◽  
Diagnosis And Treatment ◽  
Microangiopathic Hemolytic Anemia ◽  
Drug Induced ◽  
Oncology Patient ◽  
Patients With Cancer ◽  
Underlying Malignancy ◽  
Atypical Haemolytic Uraemic Syndrome

Microangiopathic hemolytic anemia (MAHA) in patients with cancer requires urgent diagnosis and treatment. MAHA associated with thrombocytopenia, suggests a thrombotic microangiopathy (TMA), where there is thrombus formation affecting small or larger vessels. It may be directly related to the underlying malignancy (either the initial presentation or with progressive disease); to its treatment or it may be a separate incidental diagnosis. Although less common, it is vital to differentiate incidental thrombotic thrombocytopenia purpura (TTP) or atypical haemolytic uraemic syndrome (aHUS) in cancer patients presenting with a TMA as quickly as possible, as they have different treatment strategies, and prompt initiation of treatment has a critical impact on outcome. In the oncology patient, widespread microvascular metastases or extensive bone marrow involvement can cause MAHA and thrombocytopenia. A disseminated intravascular coagulation (DIC) picture may be precipitated by sepsis or driven by the cancer itself. Cancer therapies may cause a TMA either by dose-dependent toxicity, or an idiosyncratic immune-mediated reaction after development of drug-dependent antibodies. Many of the causes of TMA seen in the oncology patient do not respond to plasma exchange and, where feasible, treatment of the underlying malignancy is important in controlling both cancer-TMA and DIC driven by the disease. The potential for drug-induced TMA should be considered and any putative causal agent stopped. We will discuss the differential diagnosis and treatment of MAHA in patients with cancer using clinical cases to highlight management principles.

Cancer-Related Microangiopathic Hemolytic Anemia

Medicine ◽  
2012 ◽  
Vol 91 (4) ◽  
pp. 195-205 ◽  
Author(s):  
Klaus Lechner ◽  
Hanna Lena Obermeier
Keyword(s):  
Hemolytic Anemia ◽  
Microangiopathic Hemolytic Anemia

scholarly journals Paraneoplastic polymyositis presenting as a clinically occult breast cancer

2017 ◽  
Vol 99 (2) ◽  
pp. e40-e43 ◽  
Author(s):  
N Merali ◽  
M Yousuff ◽  
V Pronisceva ◽  
A Poddar
Keyword(s):  
Paraneoplastic Syndrome ◽  
Rare Case ◽  
Primary Tumour ◽  
Imaging Studies ◽  
Occult Breast Cancer ◽  
Symptom Stability ◽  
Underlying Malignancy ◽  
Neurological Presentation ◽  
Complete History ◽  
Metaplastic Breast Carcinoma

Paraneoplastic syndrome affects less than 1% of cancer patients. Diagnosis of paraneoplastic syndrome with neurological presentation requires screening for an underlying malignancy, including a complete history, physical examination and imaging studies. Treatment often results in symptom stability, rather than improvement. Paraneoplastic polymyositis can precede or instantaneously occur at diagnosis or treatment of a primary tumour, while neurological symptoms can persist even following cancer treatment. We report a rare case of metaplastic breast carcinoma with an unusual presentation of paraneoplastic polymyositis.

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