Malignancy Associated Microangiopathic Hemolytic Anemia and Thrombocytopenia

Abstract

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.

Malignancy‑Associated Microangiopathic Hemolytic Anemia and Thrombocytopenia

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Sir, Abdulla et al nicely described two Indian patients who presented with microangiopathic hemolytic anemia (MAHA) and thrombocytopenia due to disseminated malignancy (DM). [1] I presume that underlying human immunodeficiency virus (HIV) infection might contribute to the revelation of DM in the studied two patients. That contribution could be addressed in dual aspects.

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