title: Cold agglutinin disease in fibrolamellar hepatocellular carcinoma: a rare association with a rare cancer variant.
abstract: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia. Although it can occur secondary to lymphoproliferative disorders and autoimmune or infectious diseases, CAD is rarely reported as secondary to solid tumors. We report a case of a woman aged 18 years diagnosed with a well-differentiated hepatocellular carcinoma of the fibrolamellar subtype, who was shown to have CAD also. Her general condition, including CAD, improved after targeted therapy with sorafenib for the hepatocellular carcinoma and only conservative measures for the CAD that consisted of avoidance of cold. In summary, although it is an extremely rare association and less common than lymphoproliferative disorders, CAD can be associated with solid tumors.
authors.affiliation: Department of Internal Medicine, Main Hospital, King Fahad Medical City, Riyadh, Saudi Arabia. khalidosis@hotmail.com
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Matham
authors.forename: Iehab
authors.initials: I
authors.lastname: Alabed
authors.forename: Syed Z A
authors.initials: SZ
authors.lastname: Zaidi
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Qushmaq
mesh_terms: D000293:Adolescent; D000744:Anemia, Hemolytic, Autoimmune / Q000209:etiology*; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001557:Benzenesulfonates / Q000494:pharmacology / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000494:pharmacology / Q000627:therapeutic use; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib