Parveen Shahida, Mukhtar Rubina, Shafee Shazia, Mehmood Rubaida
Department of Obstetric and Gyneacology Nishtar Hospital, Multan, Pakistan.
Multan Institute of Nuclear Medicine and Radiotherapy (MINAR) Cancer Hospital, Multan, Pakistan.
J Pak Med Assoc. 2019 Jul;69(7):1047-1048.
Evans syndrome is a rare autoimmune disease in which an individual's antibodies attacks the body's own red blood cells and platelets.1 There is a coexistence of Immune thrombocytopenia (ITP) with Autoimmune haemolytic anaemia (AIHA) and both of these events may occur simultaneously or one follows the other. 2 Association of Evans syndrome with pregnancy is very rare, and only a few cases have been published in medical literature. No definite treatment protocols are defined. Treatment options during pregnancy are further limited due to concerns of teratogenic effect of pharmacological agents. 3 Evans syndrome can be diagnosed with a full blood count film and a Coombs test. We describe here a rare case that was diagnosed as Evans syndrome during pregnancy that resulted in birth of stillborn twins after the case became complicated with the onset of Eclampsia. We have also briefly discussed the pathophysiology, the possible treatment options during pregnancy and prenatal outcome of Evans syndrome. This case was presented in June 2015 at the outpatient department of Obstetrics & Gynecology in Nishtar Medical College and Hospital, Multan.
伊文斯综合征是一种罕见的自身免疫性疾病，患者体内的抗体攻击自身的红细胞和血小板。1 免疫性血小板减少症（ITP）与自身免疫性溶血性贫血（AIHA）并存，这两种情况可能同时发生，也可能先后出现。2 伊文斯综合征与妊娠相关极为罕见，医学文献中仅发表了少数病例。目前尚无明确的治疗方案。由于担心药物致畸作用，孕期的治疗选择更加有限。3 伊文斯综合征可通过全血细胞计数涂片和库姆斯试验进行诊断。我们在此描述一例罕见病例，该患者在孕期被诊断为伊文斯综合征，在子痫发作病情复杂化后产下死胎双胞胎。我们还简要讨论了伊文斯综合征的病理生理学、孕期可能的治疗选择及产前结局。该病例于2015年6月在木尔坦尼什塔尔医学院医院妇产科门诊就诊时被提出。
