与妊娠和新冠病毒感染相关的伊文斯综合征
Evans Syndrome Associated with Pregnancy and COVID-19 Infection.
作者信息
Vadlamudi Gayathri, Hong Leah, Keerthy Madhurima
机构信息
Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, MI, USA.
出版信息
Case Rep Obstet Gynecol. 2020 Aug 18;2020:8862545. doi: 10.1155/2020/8862545. eCollection 2020.
BACKGROUND
Evans syndrome (ES) is a chronic autoimmune disease characterized by autoimmune hemolytic anemia along with immune thrombocytopenic purpura. Few case reports of ES in pregnancy have been published, and ES may be difficult to distinguish from other diagnoses more common in pregnancy. Guidelines for treatment of ES are not well-defined.
CASE
A 23-year-old multigravid woman in active labor was found to have severe anemia and thrombocytopenia. She was diagnosed with ES and started on immunosuppressive treatments for persistent immune thrombocytopenic purpura. In the postpartum period, she was found to have coronavirus (COVID-19) infection and acute pulmonary embolism.
CONCLUSION
Evans syndrome is a challenge to diagnose in pregnancy and poses important considerations for intrapartum and postpartum management.
背景
伊文氏综合征（ES）是一种慢性自身免疫性疾病，其特征为自身免疫性溶血性贫血伴免疫性血小板减少性紫癜。关于妊娠合并伊文氏综合征的病例报告很少，而且伊文氏综合征可能难以与妊娠中更常见的其他诊断相区分。伊文氏综合征的治疗指南尚不明确。
病例
一名23岁多胎妊娠且处于活跃分娩期的女性被发现患有严重贫血和血小板减少症。她被诊断为伊文氏综合征，并开始接受针对持续性免疫性血小板减少性紫癜的免疫抑制治疗。产后，她被发现感染了冠状病毒（COVID-19）并患有急性肺栓塞。
结论
伊文氏综合征在妊娠期间诊断具有挑战性，并且在产时和产后管理方面存在重要考量。
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