A 20-Year-Old Woman with Hashimoto's Thyroiditis and Evans' Syndrome.
10.3349/ymj.2006.47.3.432
- Author:
Mi Yeon KANG
1
;
Jong Ryeal HAHM
;
Tae Sik JUNG
;
Gyeong Won LEE
;
Deok Ryong KIM
;
Myoung Hee PARK
Author Information
1. Departments of 1Internal Medicine, Gyeongsang National University, Jinju, Korea. gshp.gsnu.ac.kr
- Publication Type:Case Report ; Research Support, Non-U.S. Gov't
- Keywords:
Thyroiditis;
anemia;
hemolytic;
autoimmunity;
purpura;
thrombocytopenia
- MeSH:
Purpura, Thrombocytopenic/blood/*complications;
Humans;
Hashimoto Disease/*complications/radionuclide imaging;
Female;
Anemia, Hemolytic, Autoimmune/blood/*complications;
Adult
- From:Yonsei Medical Journal
2006;47(3):432-436
- CountryRepublic of Korea
- Language:English
-
Abstract:
Here we report the case of a 20-year-old female patient previously diagnosed with Hashimoto's thyroiditis and overt hypothyroidism, and who had been taking synthetic thyroxine (100micro/day) for eight months. She experienced intermittent dizziness and generalized weakness, and was diagnosed as having severe autoimmune hemolytic anemia (AIHA). We prescribed prednisolone treatment and continued synthetic thyroxine administration. Two years and five months later, she developed idiopathic thrombocytopenic purpura (ITP) and was diagnosed with Evans' syndrome. Thereafter, laparoscopic splenectomy was performed because her autoimmune hemolytic anemia was refractory and dependent on steroid therapy. The HLA genotypes of the patient were HLA-A*020101/A*2602, HLA-B*270502/B*5401, HLA-Cw*0102/Cw*020202, HLA-DRB1*0404/DRB1*0405, and HLA-DQB1*0302/DQ B1*0401. Hashimoto's thyroiditis is often associated with other nonendocrine autoimmune diseases, and antithyroid antibodies are frequently observed in Evans' syndrome (coexistence of AIHA and ITP). However, there is no report of Evans' syndrome developing in patients with overt hypothyroidism and Hashimoto's thyroiditis. This case suggests that three autoimmune diseases (AIHA, ITP, and Hashimoto's thyroiditis) might share a common immunogenetic pathway in pathogenesis.
