Nakamura Yuko, Arai Yukihiro, Nakamura Fumihiko, Maki Kazuhiro, Aoyagi Arina, Saito Kenji, Mitani Kinuko
Department of Hematology, Dokkyo University School of Medicine.
Rinsho Ketsueki. 2002 Mar;43(3):204-6.
A 69-year-old man was diagnosed as having idiopathic thrombocytopenic purpura (ITP) in April 2000, and treated with prednisolone (PSL) without effect. Splenectomy performed in June 2000 had only a transient and marginal influence on his platelet count. Two months later, he developed autoimmune hemolytic anemia (AIHA) without Coombs test positivity, and his diagnosis was changed to Coombs-negative Evans syndrome. Treatment with PSL led to recovery of his hemoglobin level, but not his platelet count. Although the mechanism responsible for development of AIHA after splenectomy in this patient with ITP remains unknown, close observation is required for any association with other autoimmune diseases such as SLE.
