A Rare Case of Autoimmune Hemolytic Anemia in Pancreatic Adenocarcinoma

Autoimmune hemolytic anemia (AIHA) is the immune-mediated destruction of red blood cells leading to anemia. It is a well-known paraneoplastic syndrome in hematological malignancies, particularly lymphoproliferative disorders but rarely reported in solid tumors. In this report, we describe the case of a 79-year-old gentleman who presented with mixed AIHA, initially treated with methylprednisolone and rituximab, resulting in laboratory improvement. CT abdomen and pelvis showed a 3.6 cm pancreatic tail mass concerning for neoplasm with splenic vein thrombosis and carcinomatosis. The biopsy revealed pancreatic adenocarcinoma. Methylprednisolone was changed to prednisone and his hemoglobin remained stable throughout the hospital course. This case presents an extremely rare association between AIHA and pancreatic adenocarcinoma.