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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


BARBOZA-RETANA, Jorge; BOGANTES-LEDEZMA, Pilar; CARBALLO-GUTIERREZ, William  and  DIAZ-CAMACHO, Jorge. Evans Syndrome of Sudden onset in Pregnancy. Acta méd. costarric [online]. 2011, vol.53, n.4, pp.210-212. ISSN 0001-6002.

Thrombocytopenia complicates up to 10% of pregnancies. Evans syndrome is the coexistence of immune thrombocytopenia with autoimmune hemolytic anemia. We report a case of Evans syndrome during pregnancy complicated by preeclampsia and fetal neutropenia. A 20year-old primigravida, previously healthy, presented at 34 weeks of gestation epigastric pain, thrombocytopenia and preeclampsia. She underwent cesarean delivery for HELLP syndrome. In the 25th postpartum day, she was readmitted to the hospital with severe thrombocytopenia, platelet count in 2000x mm3, anemia, hemoglobin 5.3 g/dl and fever. The direct Coombs was positive and subsequent analysis showed the presence of platelet antibodies, and anticardiolipin. She received blood and platelet transfusions. She was treated with prednisone, plasmapheresis, azathioprine, and finally recovered 10 days in an intensive care unit.

Keywords : Evans syndrome; thrombocytopenia; autoimmune hemolytic anemia; pregnancy.

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