Salehizadeh Saeideh, Naser Moghadasi Abdorreza, Sahrain Mohammad Ali
Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Caspian J Intern Med. 2020 May;11(3):343-345. doi: 10.22088/cjim.11.3.343.
Evans syndrome is an uncommon autoimmune disorder manifested by fatigue, jaundice, pallor, purpura and petechiae. The main characteristics of this rare disease are simultaneous or sequential existence of positive anti-globulin test, immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA). Evans syndrome as an autoimmune disorder can be associated with other diseases. The concomitancy of Evans syndrome and multiple sclerosis (MS) has not been reported so far. In this case study, a -21-year old male with concomitant Evans syndrome and MS has been reported.
A 21-year-old male of Iranian origin and known case of Evans syndrome, was referred to our hospital for better evaluation. Evans syndrome was presented with acute jaundice, purpura, petechiae, and easy bruising when he was 9.He was under treatment of corticosteroid and cytotoxic agents, and presented with left lower extremity paresis for 5 months before admission to our hospital. According to neuroimaging and pathologic results, multiple sclerosis (MS) was diagnosed. Hence, we decided to treat the patient with rituximab. The patient has been stable without any further exacerbation or increase in disability progression after 2 years from diagnosis.
Evans syndrome can be associated with other autoimmune disorders. For our case, we have reported this association with MS.
伊文氏综合征是一种罕见的自身免疫性疾病，表现为疲劳、黄疸、面色苍白、紫癜和瘀点。这种罕见疾病的主要特征是抗球蛋白试验阳性、免疫性血小板减少症（ITP）和自身免疫性溶血性贫血（AIHA）同时或相继出现。伊文氏综合征作为一种自身免疫性疾病，可能与其他疾病相关。伊文氏综合征与多发性硬化症（MS）并存的情况迄今尚未见报道。在本病例研究中，报告了一名患有伊文氏综合征和MS的21岁男性。
一名21岁的伊朗裔男性，已知患有伊文氏综合征，因需要更好的评估而转诊至我院。他9岁时出现急性黄疸、紫癜、瘀点和易瘀伤，被诊断为伊文氏综合征。他一直在接受皮质类固醇和细胞毒性药物治疗，入院前5个月出现左下肢轻瘫。根据神经影像学和病理结果，诊断为多发性硬化症（MS）。因此，我们决定用利妥昔单抗治疗该患者。自诊断以来2年，患者病情稳定，未出现任何进一步恶化或残疾进展加剧的情况。
伊文氏综合征可能与其他自身免疫性疾病相关。就我们的病例而言，我们报告了其与MS的这种关联。
