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Case Report

EJMCR. 2020; 4(3): 100-102

Intravascular hemolytic anemia and renal failure caused by myxoma

Elsa Soares, Patricia Valerio, Catarina Abrantes, Teresa Furtado, Ana Azevedo, Ana Farinha, Jose Assuncao.

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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.

Key words: Cardiac tumor, myxoma, embolization, renal failure, hemolytic anemia

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