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Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 April;179(4):311-3

DOI: 10.23736/S0393-3660.19.04197-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Paraneoplastic microangiopathic anemia with thrombocytopenia

Inês ALBUQUERQUE 1 , Inês NOGUEIRA 2, Iolanda VIEIRA 3, Vanessa CHAVES 1, Inês FERREIRA 1, Pedro RODRIGUES 1, Manuela DIAS 1, Jorge ALMEIDA 1

1 Department of Internal Medicine, São João University Hospital, Porto, Portugal; 2 Department of Oncology, São João University Hospital, Porto, Portugal; 3 Department of Oncology, Portuguese Institute of Oncology, Porto, Portugal



A female patient in her 50’s was admitted to the hospital ward with microangiopathic hemolytic anemia and thrombocytopenia (MAT). Thrombocytopenic thrombotic purpura (TTP) was the initial presumptive diagnosis and plasma exchange (PEX) was initiated. As there was no clinical response and ADAMTS13 activity was normal, we pursued alternative diagnosis and found that MAT was secondary to metastatic breast cancer. This case is illustrative of the challenging diagnosis and treatment decisions related to the differential diagnosis between thrombocytopenic thrombotic purpura and other causes of MAT and highlights the importance of early detection of paraneoplastic MAT in prognosis.


KEY WORDS: ADAMTS13 protein; Thrombocytopenia; Hemolytic anemia

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