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Microangiopathic Hemolytic Anemia (MAHA), High Alkaline Phosphatase and D-dimer Levels and Bone Marrow Infiltration as the First Presentation of Metastatic Signet Ring Cell Carcinoma of Gastric Origin: A Rare Case Report

Abstract

Sebnem Izmir Guner, Teoman Yanmaz, Didem Karacetin, Muhammed Fatih Aydin, Ali Onder Atca and Oner Dogan

Microangiopathic haemolytic anaemia (MAHA) occurs seldom as a paraneoplastic syndrome in some solid tumors, but MAHA companionship by signet ring cell carcinoma (SRCC) of gastric origin is very rare. This case report describes a 46-year-old man who initially presented with unendurable back and abdomen pain, he has also jaundice, anaemia, thrombositopenia, elevated bilirubin-D-dimer and alkaline phoshatase levels. He was diagnosed with MAHA on the basis of the laboratory findings that revealed anaemia with schistocytes, and a negative direct Coombs’ test. Bone marrow and peripheral blood smear examinaton of the patients revealed out the diagnosis which was performed because of the progression of anaemia and thrombositopenia. However, the primary origin of this signet ring cell carcinoma (SRCC) was found in the stomach.

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