Intravascular hemolytic anemia and renal failure caused by myxoma
Authors: Elsa Soares, Patricia Valerio, Catarina Abrantes, Teresa Furtado, Ana Azevedo, Ana Farinha, Jose Assuncao
Background: Cardiac myxoma is the most frequent benign tumor of the heart and presents an important diagnostic challenge. Case presentation: A 51-year-old woman was admitted at the hospital for anorexia, fatigue, nausea, and vomiting for the last 10 days. Laboratory results showed hemoglobin 5.26 g/dl, platelets 83× 10^9 μl, Lactate Dehydrogenase (LDH) 348 U/l, bilirubin 2.0 mg/dl, haptoglobin 100 mg/dl, negative Coombs test, blood smear with schistocytes and urea 327 mg/dl, creatinine 8.56 mg/dl. Non-autoimmune hemolytic anemia and acute kidney injury was assumed. After seven plasma exchange treatments, she went into acute pulmonary edema. Body tomography was performed, and revealed a mass in the left atrium. She underwent atriotomy and after surgery hemoglobin values stabilized but kidney function did not improve, and she became dialysis dependent. Conclusion: Myxomas can mimic other diseases which may delay diagnosis and compromise prognosis. In this particular case, the myxoma manifested with intravascular hemolytic anemia. This is an, especially, interesting case because a myxoma caused kidney failure without recovery.
Keywords: Cardiac tumor, myxoma, embolization, renal failure, hemolytic anemia
Authors
Correspondence to:
Elsa Soares, Nephrology Department, Centro Hospitalar de Setubal, Portugal elsa.qsoares@gmail.com
Publication history:
Received 24 Oct 2019
Accepted 07 Mar 2020
Published online 22 Mar 2020
Published in print 04 Apr 2020
Soares E, Valerio P, Abrantes C, Furtado T, Azevedo A, Farinha A, Assuncao J. Intravascular hemolytic anemia and renal failure caused by myxoma. EJMCR. 2020; 4(3): 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares E, Valerio P, Abrantes C, Furtado T, Azevedo A, Farinha A, Assuncao J. Intravascular hemolytic anemia and renal failure caused by myxoma. https://www.ejmcr.com/?mno=69871 [Access: March 29, 2024]. doi:
10.24911/ejmcr/173-1571237973
Soares E, Valerio P, Abrantes C, Furtado T, Azevedo A, Farinha A, Assuncao J. Intravascular hemolytic anemia and renal failure caused by myxoma. EJMCR. 2020; 4(3): 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares E, Valerio P, Abrantes C, Furtado T, Azevedo A, Farinha A, Assuncao J. Intravascular hemolytic anemia and renal failure caused by myxoma. EJMCR. (2020), [cited March 29, 2024]; 4(3): 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares, E., Valerio, . P., Abrantes, . C., Furtado, . T., Azevedo, . A., Farinha, . A. & Assuncao, . J. (2020) Intravascular hemolytic anemia and renal failure caused by myxoma. EJMCR, 4 (3), 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares, Elsa, Patricia Valerio, Catarina Abrantes, Teresa Furtado, Ana Azevedo, Ana Farinha, and Jose Assuncao. 2020. Intravascular hemolytic anemia and renal failure caused by myxoma. European Journal of Medical Case Reports, 4 (3), 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares, Elsa, Patricia Valerio, Catarina Abrantes, Teresa Furtado, Ana Azevedo, Ana Farinha, and Jose Assuncao. "Intravascular hemolytic anemia and renal failure caused by myxoma." European Journal of Medical Case Reports 4 (2020), 100-102. doi:
10.24911/ejmcr/173-1571237973
Soares, Elsa, Patricia Valerio, Catarina Abrantes, Teresa Furtado, Ana Azevedo, Ana Farinha, and Jose Assuncao. "Intravascular hemolytic anemia and renal failure caused by myxoma." European Journal of Medical Case Reports 4.3 (2020), 100-102. Print. doi:
10.24911/ejmcr/173-1571237973
Soares, E., Valerio, . P., Abrantes, . C., Furtado, . T., Azevedo, . A., Farinha, . A. & Assuncao, . J. (2020) Intravascular hemolytic anemia and renal failure caused by myxoma. European Journal of Medical Case Reports, 4 (3), 100-102. doi:
10.24911/ejmcr/173-1571237973