Elsevier

Archives de Pédiatrie

Volume 5, Issue 1, January 1998, Pages 41-44
Archives de Pédiatrie

Fait clinique
Anémie hémolytique auto-immune associée à un tératome mature de l'ovaireAutoimmune hemolytic anemia associated with a mature ovarian teratoma

https://doi.org/10.1016/S0929-693X(97)83466-5Get rights and content

Résumé

L'association anémie hémolytique auto-immune et tératome mature de l'ovaire est rare, notamment chez l'enfant, mais mérite d'être connue car le traitement du tératome permet la guérison de l'anémie.

Observation.

Une eni'ant de 9 ans a été hospitalisée pour une anémie hémolytique. L'enquête étiologique révèle une origine auto-immune (présence d'autoanticorps IgG-complément) et trouve une tumeur ovarienne sur l'échographie abdominopelvienne. L'exérèse chirurgicale est complète et non compliquée. L'examen anatomopathologique a conclu à un tératome mature. L'anémie, de même que les stigmates d'auto-immunité, se sont corrigés dans les semaines suivant l'intervention et l'enfant va bien avec plusieurs mois de recul.

Conclusion.

Ce second cas pédiatrique rapporté montre l'intérêt de rechercher un tératome de l'ovaire par une échographie chez toute fillette présentant une anémie hémolytique auto-immune, puisque l'exérèse chirurgicale de la tumeur suffit pour guérir l'association.

Summary

The association of autoimmune hemolytic anemia and mature teratoma of the ovary is rare, particularly in childhood, but must be known and looked for since the treatment of teratoma allows to cure anemia as well.

Case report.

A 9 year-old girl was admitted for hemolytic anemia. The etiologic work-up revealed an autoimmune mechanism (IgG autoantibodies with complement), as well as an ovarian tumor after ultrasound sonography of the abdomen and pelvis. Surgical excision of the tumor was complete and uncomplicated. Pathological examination concluded to a mature teratoma. Anemia, as well as the signs of autoimmunity, disappeared a few weeks later and the child is doing well with several months of follow-up.

Conclusion.

This second reported pediatric case shows that an ovarian teratoma should be searched for with ultrasound sonography in any girl presenting with autoimmune hemolytic anemia, since surgical excision is sufficient to cure both anemia and the tumor.

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    This ovarian teratoma could have been the cause of this woman's death because sometimes the development of teratomas results in displacement and functional disturbances of adjacent organs (Tandon et al., 2010). They can be associated with infection (Wolski and Jasinski, 1981) and hemolytic anemia (Glorieux et al., 1998). Pregnancy seems to favor the development of some complications, and occasionally the teratoma itself may cause obstruction during labor (Maslin et al., 2002; Sloan, 1963).

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