An Unexpected Malignancy Behind Pediatric Microangiopathic Hemolytic Anemia: Gastric Signet Ring Cell Carcinoma.

BACKGROUND

In the pediatric population, gastrointestinal (GIS) cancers are rare, and paraneoplastic syndromes associated with these malignancies are even more uncommon.

OBSERVATIONS: A 15-year-old patient with a clinical presentation of microangiopathic hemolytic anemia (MAHA) resistant to plasma exchange was found to have metastatic adenocarcinoma in a biopsy of a supraclavicular lymphadenopathy. Subsequent endoscopy revealed gastric signet ring cell carcinoma.

CONCLUSIONS

This case highlights that malignancy should be suspected in pediatric patients with MAHA who are unresponsive to plasma exchange and have normal ADAMTS-13 activity.