Warm Autoimmune Hemolytic Anemia Associated with Pancreatic Adenocarcinoma Showing Ectopic Expression of Band 3 Protein: A Case Report.
Akari Goto, Makoto Yoshida, Ryosei Murai et al.
✦ AI-curated · Sources linked
Case in brief
A 73-year-old woman with unresectable pancreatic adenocarcinoma developed warm autoimmune hemolytic anemia that was refractory to steroids. Prednisolone partially improved the anemia but did not control hemolysis. After modified FOLFIRINOX followed by gemcitabine plus nab-paclitaxel, both the tumor and anemia improved, allowing steroid tapering. Conversion surgery showed ectopic band 3 expression in the tumor cells.
What made this case unusual
The pancreatic tumor showed ectopic band 3 expression, raising the possibility that anti-band 3 antibodies contributed to the paraneoplastic hemolysis.
Diagnostic / clinical pearl
In steroid-refractory warm AIHA associated with pancreatic adenocarcinoma, assess the clinical course alongside tumor response; in this case, anemia and hemolysis improved with tumor-directed chemotherapy.