# Case Report: Autoimmune hemolytic anemia associated with ovarian teratoma in a 13-year-old: a rare paraneoplastic presentation

## TL;DR

A 13-year-old girl with a rare case of autoimmune hemolytic anemia linked to an ovarian tumor showed full recovery after surgery.

## Contribution

This case report presents a rare paraneoplastic presentation of AIHA associated with a benign ovarian teratoma in a pediatric patient.

## Key findings

- The patient's AIHA resolved completely after surgical removal of the ovarian teratoma.
- No blood transfusions were required during the surgical intervention.
- There was no recurrence of hemolysis during the 2-month follow-up.

## Abstract

Autoimmune hemolytic anemia (AIHA) is a rare and potentially life-threatening condition in the pediatric population. While often associated with autoimmune or lymphoproliferative disorders, its occurrence in conjunction with benign ovarian tumors, such as mature cystic teratomas, is exceptionally rare.

A 13-year-old previously healthy female presented with a one-week history of progressive pallor, jaundice, and fatigue. Initial laboratory tests revealed severe anemia (Hb 5.6 g/dL), elevated LDH, indirect hyperbilirubinemia, undetectable haptoglobin, and a positive direct antiglobulin test (DAT) for IgG, confirming warm AIHA. Imaging studies, including pelvic ultrasound and MRI, identified a large complex cystic ovarian mass, consistent with a mature cystic teratoma. The patient underwent exploratory laparotomy with right salpingo-oophorectomy without requiring blood transfusions. Postoperatively, there was complete resolution of hemolysis, normalization of laboratory values, and no recurrence over a 2-month follow-up period.

This case highlights a diagnostic challenge and underscores the importance of recognizing paraneoplastic AIHA in children, even in the context of benign tumors. It also supports a potential autoimmune–tumor association, emphasizing the value of timely diagnosis and surgical intervention.