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CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2020; 41(06): 909-912
DOI: 10.4103/ijmpo.ijmpo_182_20
Case Report with Review of Literature

Case Report on Autoimmune Hemolytic Anemia: A Mask of Malignancy!

Abhilasha Sampagar
Department of Pediatrics, KAHER'S Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
,
Neha Giridhar Patil
Department of Pediatrics, KAHER'S Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
,
Sandip Bartakke
Department of Hematology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
,
S Shrividya
Department of Hematology, Aditya Birla Memorial Hospital, Pune, Maharashtra, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

A 10-year-old boy with autoimmune hemolytic anemia (AIHA) was treated at a local setup with repeated blood transfusions and steroids considering an idiopathic etiology. After 7 months of unresponsiveness, the child started developing recurrent fever with night sweats and pain in the abdomen which was diagnosed as tuberculosis on account of granulomatous necrotizing lesion on computed tomography (CT)-guided lymph node biopsy and treated for the same. Four months later, when the child presented to our center in anemic heart failure, work-up with positron emission tomography-CT and excisional biopsy of mesenteric lymph node led to the diagnosis of advanced Hodgkin's lymphoma with B symptoms. AIHA in pediatric age group, unlike in adults, is usually secondary. Our report stresses on a thorough evaluation of AIHA as it can mask a malignancy for a long duration and alter its course if treated with steroids, making the patient resistant to further chemotherapy.

Keywords

Autoimmune hemolytic anemia - Hodgkin's lymphoma - tuberculosis


Publication History

Received: 22 April 2020

Accepted: 23 August 2020

Article published online:
14 May 2021

© 2020. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Fan J, He H, Zhao W, Wang Y, Lu J, Li J. et al. Clinical features and treatment outcomes of childhood autoimmune haemolytic anemia: A retrospective analysis of 68 cases. J Pediatr Hematol Oncol 2016; 38: e50-5
    CrossrefPubMedSearch in Google Scholar
  • 2 Packman CH. The clinical pictures of autoimmune hemolytic anemia. Transfus Med Hemother 2015; 42: 317-24
    CrossrefPubMedSearch in Google Scholar
  • 3 Uy AB, Garcia AM, Manguba A, Loyola A. Tuberculosis: The great lymphoma pretender. Int J Cancer Res Mol Mech 2016; 2: 1-4
    Search in Google Scholar
  • 4 Xirox N, Binder T, Anger B, Bohlke J, Heimpel H. Idiopathic thrombocytopenic purpura and autoimmune haemolytic anemia in Hodgkin's disease. Eur J Haematol 1988; 40: 437-41
    CrossrefPubMedSearch in Google Scholar
  • 5 Lechner K, Chen YA. Paraneoplastic autoimmune cytopenias in Hodgkin's lymphoma. Leuk Lymphoma 2010; 51: 469-74
    CrossrefPubMedSearch in Google Scholar
  • 6 Orkin SH, Nathan DG, Ginsburg D, Look AT, Fisher DE, Lux S. Nathan and Oski's hematology and oncology of infancy and childhood E-book. Philadelphia : Elsevier Health Sciences; 2014
    Search in Google Scholar
  • 7 Ladogana S, Maruzzi M, Samperi P, Perrotta S, Del Vecchio GC, Notarangelo LD. et al. AIHA committee of the Italian association of paediatric onco-hematology (AIEOP) diagnosis and management of newly diagnosed childhood autoimmune hemolyticanemia.Recommendations from the red cell study group of the paediatric haemato-oncology Italian association. Blood Transfus 2017; 15: 259-67
    PubMedSearch in Google Scholar
  • 8 Kan E, Levi I, Benharroch D. Alterations in the primary diagnosis of lymphomas pretreated with corticosteroid agents. Leuk Lymphoma 2011; 52: 425-8
    CrossrefPubMedSearch in Google Scholar
  • 9 Allin D, David S, Jacob A, Mir N, Giles A, Gibbins N. Use of core biopsy in diagnosing cervical lymphadenopathy: A viable alternative to surgical excisional biopsy of lymph nodes?. Ann R Coll Surg Engl 2016; 5: 1-3
    Search in Google Scholar
  • 10 Schwartz CL, Chen L, McCarten K, Wolden S, Constine LS, Hutchison RE. et al. Childhood Hodgkin International Prognostic Score (CHIPS) predicts event-free survival in Hodgkin lymphoma: Areport from the Children's Oncology Group. Pediatric Blood and Cancer 2017; 64: e26278
    CrossrefPubMedSearch in Google Scholar