Use of Splenectomy to Treat Evans Syndrome Following an ABO-Matched Liver Transplant.
10.3904/kjm.2015.88.4.464
- Author:
Ji Hyun YUN
1
;
Jee Hwan AHN
;
Dong Hui CHO
;
Taeeun KIM
;
Gi Won SONG
;
Sung Gyu LEE
;
Kyoo Hyung LEE
Author Information
1. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. khlee2@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Autoimmune hemolytic anemia;
Idiopathic thrombocytopenic purpura;
Liver transplantation;
Splenectomy
- MeSH:
Adult;
Anemia, Hemolytic, Autoimmune;
Calcineurin;
Graft vs Host Disease;
Humans;
Immunoglobulins;
Liver Transplantation;
Liver*;
Purpura, Thrombocytopenic, Idiopathic;
Splenectomy*;
Rituximab
- From:Korean Journal of Medicine
2015;88(4):464-468
- CountryRepublic of Korea
- Language:English
-
Abstract:
Evans syndrome is a rare complication that develops in adults after liver transplantation. The possible etiologies include ABO mismatch, viral infection, post-transplantation lymphoproliferative disease, graft-versus-host disease, and the use of certain immunosuppressive drugs (e.g., calcineurin inhibitors). Here, we present a case of Evans syndrome that developed after an ABO-matched liver transplant. Glucocorticosteroid, intravenous immunoglobulin, and alternative immunosuppressant therapies all failed. Weekly rituximab (375 mg/m2) was then administered for 4 weeks. The cytopenia improved transiently after the second dose of rituximab, but soon worsened again. However, the cytopenia normalized after a splenectomy.
