妊娠に伴うM-CSFの増加が病態に関与したと思われる Evans 症候群の1例

• 小宮山 豊

  関西医科大学病態検査

• 野村 昌作

  関西医科大学第一内科

• 香川 英生

  関西医科大学第一内科

• 福原 資郎

  関西医科大学第一内科

書誌事項

タイトル別名

• A case of Evans Syndrome with Pregnancy-induced Elevation of Macrophage-colony Stimulating Factor

抄録

We report a case of Evans syndrome with pregnancy-induced elevation of macrophagecolony stimulating factor (M-CSF). A 26-year-old woman presented in May 1989 because of slight dizziness and dyspnea. Peripheral blood analysis revealed RBC 224×10⁴/μl, Hb 7.8g/dl, Ht 23.8%, Ret 5.1%, WBC 9, 500/μl, Plt 23.5×10⁴/μl, LDH 777U/l, total bilirubin 1.0mg/dl, and haptoglobin <10mg/dl. A direct Coombs test was positive and IgG autoantibody was identified. The patient was diagnosed as having the idiopathic warm antibody type of autoimmune hemolytic anemia (AIHA), and therapy was started with prednisolone 30mg/day. The anemia improved during steroid therapy. The patient delivered her first child in December 1989. In April 1991, she had both AIHA and idiopathic thrombocytopenic purpura (ITP), and was diagnosed as having Evans syndrome. After her second delivery, she underwent γ-globulin therapy and splenectomy. In March 1995, she delivered her third child, without progression of AIHA or ITP. Except for during the third pregnancy, which occurred after splenectomy, gestation was associated with worsened AIHA and ITP as well as elevation of M-CSF. These findings suggest that the increase in M-CSF associated with pregnancy could contribute to the pathology of the patient in this report.

収録刊行物

• 日本血栓止血学会誌

  日本血栓止血学会誌 8 (3), 212-217, 1997

  一般社団法人 日本血栓止血学会

キーワード

• Evans syndrome
• macrophage-colony stimulating factor
• pregnancy
• splenectomy
• autoimmune hemolytic anemia

詳細情報

• CRID: 1390282679427186432
• NII論文ID: 130004262522
• NII論文ID: 10008638644
• NII書誌ID: AN10353762
• DOI: 10.2491/jjsth.8.212
• ISSN: 18808808
• ISSN: 09157441
• Web Site: https://search.jamas.or.jp/link/ui/1998001271
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
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