Autoimmune hemolytic anemia associated with clear cell renal carcinoma: A case report

Abstract

Autoimmune Hemolytic Anemia (AIHA) is hemolytic anemia characterized by auto-antibodies directed to erythrocytes. It is commonly induced by hematological neoplasms such as malignant lymphoma; however urological cancers are rarely seen in this area. We present a case of clear cell renal carcinoma that responded to right partial nephrectomy, presenting with Coombs-positive warm AIHA. A 34-year-old male patient presented with fatigue lasting for 1 week, and yellowing of the eyes and body. His hemoglobin level was 6.8 g/dL, indirect bilirubin was 9.3 mg/dL, lactate dehydrogenase (LDH) 1031 U/L and both direct and indirect Coombs tests were positive. In abdominal computed tomography, there was a 6 cm diameter mass lesion of heterogeneous density in the middle part of the right kidney. Corticosteroid treatment was started and then partial nephrectomy was performed. After surgical resection, the hemoglobin level gradually returned to normal. We detected warm AIHA associated with clear cell renal cancer. We are reporting a clear cell renal cancer that responded to corticosteroid and partial nephrectomy, who came to the hematology clinic with severe AIHA. Clear cell renal cancer should be considered in the differential diagnosis for warm AIHA, and nephrectomy might offer a treatment option for renal cell carcinoma associated AIHA.