Microangiopathic Haemolytic Anaemia Associated with Consumption Coagulopathy in a Patient with Disseminated Carcinoma

Abstract

The case of a 28 year old man with disseminated carcinoma who terminally developed a syndrome resembling thrombohaemolytic thrombocytopenic purpura is presented. Microangiopathic haemolytic anaemia as evidenced by bizarre poikilocytosis along with a consumption coagulopathy with depletion of factors I, II, V, VIII and platelets were present. At autopsy, widespread capillary and arteriolar thromboses were seen. The relative importance of primary coagulation disturbance, vascular damage, or antigen‐antibody complexing in initiating the thrombosis‐haemorrhage sequence has been discussed. The speculation that release of thromboplastic substance by the tumour was the initiating event in production of the entire thrombohaemolytic thrombocytopenic purpura‐like picture in our patient is raised.