title: Warm antibody autoimmune haemolytic anaemia associated with ovarian teratoma.
abstract: The ovarian cystic teratoma is a rare cause of autoimmune haemolytic anaemia by warm antibodies, resistant to corticotherapy, with few case reports published in the medical literature. We present a case of a 45-year-old woman admitted to hospital due to general weakness. Laboratory studies revealed macrocytic anaemia, biochemical parameters of haemolysis and peripheral spherocytosis. The direct Coombs test was positive. Viral serologies, anti-nuclear antibodies, anti-double-stranded DNA antibodies and β2-microglobulin were negative. CT scan of the thorax, abdomen and pelvis showed a heterogeneous right anexial lesion. The patient was treated with corticotherapy without improvement of anaemia. Regression of extra-vascular haemolysis and normalisation of haemoglobin was obtained only after laparoscopic splenectomy and right ooforectomy, and the histopathology of the right anexial mass revealed a cystic teratoma. Previously published cases controlled the haemolysis by surgically removing the lesion associated with splenectomy.
authors: Hospital Sao José, Serviço Medicina Interna 1.2, Lisboa, Portugal.
authors: Pedro Oliveira
authors: PO
authors: Raimundo
authors: Susana
authors: S
authors: Coelho
authors: Alexandra
authors: A
authors: Cabeleira
authors: Luis
authors: L
authors: Dias
authors: Manuela
authors: M
authors: Gonçalves
authors: Julio
authors: J
authors: Almeida
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000276:immunology*; D003298:Coombs Test; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000601:surgery; D010052:Ovariectomy; D013156:Splenectomy; D013724:Teratoma / Q000175:diagnosis / Q000276:immunology* / Q000601:surgery; D014057:Tomography, X-Ray Computed