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KMID : 0366220110460040279
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Korean Journal of Hematology
2011 Volume.46 No. 4 p.279 ~ p.282
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Evans syndrome following long-standing Hashimoto’s thyroiditis and successful treatment with rituximab
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Oh Hye-Jin
Yun Myung-Jae
Lee Seong-Tae
Oh So-Yeon
Sohn In
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Abstract
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We report a case of a 51-year-old woman with Evans syndrome (autoimmune hemolytic anemia and primary immune thrombocytopenia) and hypothyroidism. She was previously diagnosed with Hashimoto’s thyroiditis in 1994 (age, 35) and autoimmune hemolytic anemia (AIHA) 3 years ago. She was treated with oral prednisolone. After a period, in which the anemia waxed and waned, there was an abrupt development of thrombocytopenia (nadir 15×109/L) that coincided with the tapering off of prednisolone after 3 years of administration. Because her thrombocytopenia was refractory to prednisolone, we administered rituximab (375 mg/m2 weekly) for 4 weeks. Two weeks after the completion of the rituximab treatment, her platelet count was up to 92×109/L. No intermittent peaking of thyroid stimulating hormone occurred after rituximab treatment was initiated. Evans syndrome and autoimmune thyroiditis might share common pathophysiological mechanisms. This notion supports the use of rituximab in a patient suffering from these disorders.
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KEYWORD
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Evans syndrome, ITP, AIHA, Autoimmune thyroiditis
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