Autoimmune Haemolytic Anaemia and Anastomosing Haemangioma: A Possible Relationship

Abstract

This study presents the case of a patient with autoimmune haemolytic anaemia and an anastomosing haemangioma. The main dilemma is whether or not there is a relationship between the two processes and how both issues should be managed. The diagnostic methods used were analytical and imaging techniques, which proved to be inconclusive for the diagnosis of anastomotic haemangioma. Preoperative treatment with corticosteroids did not prevent anaemia, platelets, and elevated levels of total reticulocytes in the postoperative period. Surgical indication was based on with reference to the progression of proliferative activity, with tumour enlargement and the compression of the vena cava over time. The procedure involved the total surgical resection of the tumour. The indication for surgical treatment of the anastomosing haemangioma and the decrease in alpha-fetoprotein after tumour resectioning are the most relevant data, although alpha-fetoprotein increased again after a few weeks. Angiogenesis resulting from the formation of erythroblastic islands in the tumour periphery, and clonal expansions may be a compensatory mechanism of haemolysis caused by autoimmune haemolytic anaemia. In conclusion, erythropoietic clonal proliferation in anastomosing haemangioma may be secondary to autoimmune haemolytic anaemia and compensates for the loss of red blood cells in bone marrow affected by senescence. Therefore, a possible causal relationship between autoimmune haemolytic anaemia and anastomosing haemangioma is proposed.