Mikroangiopatická hemolytická anemie jako vůdčí projev pokročilého nádorového onemocnění

Microangiopathic haemolytic anemia (MAHA) as a main symptom of a generalized tumour

Microangiopathic haemolytic anemia (MAHA) is an uncommon- although not rare- condition, which accompanies a number of diseases with a heterogeneous aetiology, including malignant tumours. MAHA may be the first sign of an as yet hidden malignant disease. The exact pathogenesis of cancer–associated MAHA is not yet fully understood. Subjective complaints and objective clinical findings are very diverse but non-specific. For this reason, laboratory tests are the key to establishing a correct diagnosis; findings exhibit a varied level of haemolytic anemia with an increase in reticulocytes, moderate to severe thrombocytopenia, signs of intravascular haemolysis and schistocytes in peripheral blood smears. Due to the fact that MAHA syndrome is usually present in late or terminal stages of malignancies, the prognosis is extremely unfavourable and most patients die within several weeks. Only early tumour diagnosis and the prompt introduction of antitumour therapy in combination with intensive supportive therapy may offer hope of success.

Key words:
microangiopathic haemolytic anemia, adenocarcinoma, schistocyte.