Disseminated malignancy can rarely present with microangiopathic hemolytic anemia
and thrombocytopenia clinically similar to thrombotic thrombocytopenic purpura (TTP),
but does not respond to plasma exchange. TTP carries a grave prognosis if plasma exchange
is delayed. Evaluating patients presenting with microangiopathic hemolytic anemia
and thrombocytopenia is challenging for clinicians. Thrombotic thrombocytopenic purpura
(TTP) should be considered in such patients and emergency plasma exchange is to be
initiated. But all the clinical features seen in TTP can be caused by a disseminated
malignancy. The awareness of such a rare presentation of disseminated malignancy helps
clinicians to avoid unnecessary delay in appropriate treatment and the complications
due to plasma exchange. We report two patients who presented with microangiopathic
hemolytic anemia and thrombocytopenia due to disseminated malignancy.
Keywords
Disseminated malignancy - microangiopathic hemolytic anemia - thrombocytopenia - thrombotic
thrombocytopenic purpura