Department of Internal Medicine, National Referral Center for Adult Immune Cytopenias Henri Mondor University Hospital, Service de Medecine Interne, CHU Hopital Henri-Mondor, Assistance Publique Hôpitaux de Paris, Université Paris-Est Créteil, 51 Av du Mal de Lattre de Tassigny, 94010 Creteil Cedex, France.
Hematol Oncol Clin North Am. 2022 Apr;36(2):381-392. doi: 10.1016/j.hoc.2021.12.004. Epub 2022 Mar 11.
Evans syndrome (ES) is a rare immune disorder defined as the simultaneous or sequential occurrence in a single patient of immune thrombocytopenia (ITP) and warm autoimmune hemolytic anemia (wAIHA) ± autoimmune neutropenia (AIN). ES represents approximately 5% to 10% of all wAIHA and 2%-5% of all ITP cases in adults and its mortality rate is high. When ITP and wAIHA occurred concomitantly, other differential diagnoses must be ruled out. ES can be primary or secondary and isolated or associated with another underlying disorder and secondary ES. The management of ES is mostly empirical with a low level of evidence. This review reports some new insights on this rare disease and provides some practical tools for the diagnosis and management of adult ES.
Evans 综合征(ES)是一种罕见的免疫性疾病,定义为同一患者同时或先后发生免疫性血小板减少症(ITP)和温抗体型自身免疫性溶血性贫血(wAIHA)±自身免疫性中性粒细胞减少症(AIN)。ES 约占所有成人 wAIHA 的 5%至 10%和所有 ITP 病例的 2%至 5%,其死亡率较高。当 ITP 和 wAIHA 同时发生时,必须排除其他鉴别诊断。ES 可为原发性或继发性、孤立性或伴有其他潜在疾病和继发性 ES。ES 的治疗主要是经验性的,证据水平较低。本综述报告了一些关于这种罕见疾病的新见解,并为成人 ES 的诊断和治疗提供了一些实用工具。