Microangiopathic Hemolytic Anemia (MAHA) as Paraneoplastic Syndrome in Metastasized Signet Ring Cell Carcinomas: Case Reports and Review of the Literature

Zusammenfassung

Wir berichten über zwei Patienten mit spontan aufgetretener mikroangiopathischer hämolytischer Anämie (MAHA) bei metastasiertem Siegelringkarzinom des Magens und CUP (carcinoma of unknown primary). In beiden Fällen präsentierte sich die mikroangiopathische hämolytische Anämie als paraneoplastisches Syndrom. Klinisch fielen die Patienten durch eine akut einsetzende Coombs-negative, hämolytische Anämie mit Fragmentozyten im peripheren Blutausstrich auf, die typisch für das MAHA-Syndrom sind. Unter supportiver Therapie und einer eingeleiteten Chemotherapie nach dem ELF- bzw. nach dem PLF-Schema konnten wir den Tumorprogress und die Hämolyse kontrollieren.

Abstract

We report on two spontaneous cases of microangiopathic hemolytic anemia (MAHA) as first manifestation due to metastasized signet ring carcinoma, one of gastric and one of unknown origin. The patients presented with an acute onset of Coombs negative hemolytic anemia and fragmentocytes in the peripheral blood smear which are typical for MAHA. These case reports present MAHA as a rare paraneoplastic syndrome in patients with metastasized signet ring carcinoma. Parallel to symptomatic treatment we started chemotherapy treatment (ELF and PLF regimen, respectively). In both cases we were able to control the MAHA and cancer progression.

Magenkarzinom - Siegelringkarzinom - paraneoplastisches Syndrom - mikroangiopathische hämolytische Anämie

Gastric carcinoma - signet ring carcinoma - paraneoplastic syndrome - microangiopathic hemolytic anemia

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