Tumour-Associated Microangiopathic Haemolytic Anaemia with Thrombocytopenia: A Narrative Review and Case Study

TL;DR

This paper discusses two cases of a rare blood disorder linked to tumors and suggests tumor removal as an effective treatment.

Contribution

The paper proposes a novel hypothesis linking mucin secretion and paraneoplastic antibodies to tumor-associated thrombotic microangiopathy.

Findings

Surgical removal of tumors resolved thrombotic microangiopathy in two cases.

Mucin secretion and paraneoplastic antibodies are hypothesized to cause endothelial damage.

Tumor treatment is suggested as preferred therapy for tumor-associated TMA.

Abstract

Thrombotic microangiopathy (TMA) is a category of diseases consisting of thrombocytopenia, microangiopathic haemolytic anaemia, and widespread occlusive microvascular thrombosis. We report two cases of a thrombotic microangiopathic syndrome associated with non-invasive mucinous cysts and mucinous adenocarcinoma. TMA was treated in both cases by surgical removal of the tumours. We hypothesise that mucin secretion in the case of non-invasive mucinous cysts and paraneoplastic secretion of antibodies in the case of mucinous adenocarcinomas are the causes of endothelial damage with thrombocytopenia and microangiopathic haemolytic anaemia. Finally, patients with TMA who exhibit unusual clinical characteristics or weak responses to plasma exchange should be examined for an underlying tumour. Tumour treatment is the preferred therapy for tumour-associated TMA.

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