Evans syndrome following long-standing Hashimoto's thyroiditis and successful treatment with rituximab.
10.5045/kjh.2011.46.4.279
- Author:
Hye Jin OH
1
;
Myung Jae YUN
;
Seong Tae LEE
;
Seung June LEE
;
So Yeon OH
;
In SOHN
Author Information
1. Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. syoh@medimail.co.kr
- Publication Type:Case Report
- Keywords:
Evans syndrome;
ITP;
AIHA;
Autoimmune thyroiditis
- MeSH:
Anemia;
Anemia, Hemolytic;
Anemia, Hemolytic, Autoimmune;
Antibodies, Monoclonal, Murine-Derived;
Female;
Humans;
Hypothyroidism;
Middle Aged;
Platelet Count;
Prednisolone;
Stress, Psychological;
Thrombocytopenia;
Thyroid Gland;
Thyroiditis;
Thyroiditis, Autoimmune;
Thyrotropin;
Rituximab
- From:Korean Journal of Hematology
2011;46(4):279-282
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of a 51-year-old woman with Evans syndrome (autoimmune hemolytic anemia and primary immune thrombocytopenia) and hypothyroidism. She was previously diagnosed with Hashimoto's thyroiditis in 1994 (age, 35) and autoimmune hemolytic anemia (AIHA) 3 years ago. She was treated with oral prednisolone. After a period, in which the anemia waxed and waned, there was an abrupt development of thrombocytopenia (nadir 15x10(9)/L) that coincided with the tapering off of prednisolone after 3 years of administration. Because her thrombocytopenia was refractory to prednisolone, we administered rituximab (375 mg/m2 weekly) for 4 weeks. Two weeks after the completion of the rituximab treatment, her platelet count was up to 92x10(9)/L. No intermittent peaking of thyroid stimulating hormone occurred after rituximab treatment was initiated. Evans syndrome and autoimmune thyroiditis might share common pathophysiological mechanisms. This notion supports the use of rituximab in a patient suffering from these disorders.
