Document Detail


Evans' syndrome in pregnancy: a systematic literature review and two new cases.
MedLine Citation:
PMID:  20031296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Evans' syndrome, the coexistence of immune thrombocytopenia (ITP) with autoimmune haemolytic anaemia (AIHA), is rare in pregnancy, with a few published cases. Concerns about the teratogenic effect of pharmacological agents used in the management of Evans' syndrome limit the treatment options in pregnancy. In this paper we performed a systematic review of the literature of all published cases with Evans' syndrome in pregnancy and we report two new cases. The review was performed by searching the electronic databases PubMed, EMBASE, Cochrane Library and Google scholar up to the end of December 2008. The selection criteria were Evans' syndrome in pregnancy; autoimmune haemolytic anaemia; immune thrombocytopenia. Thirteen papers reporting 14 pregnancies in women with Evans' syndrome have been published: 7 papers are written in English. Evans' syndrome can be diagnosed with a full blood count, film and Coombs testing. It runs a more benign course in pregnancy than in non-pregnant state (notably neutropenia does not occur) and very often resolves post-delivery. The fetal outcome may be less favourable: a minority of fetuses are affected by transplacental passage of antibody and have a significant morbidity and mortality. With appropriate treatment, women with Evans' syndrome can have successful pregnancies, with a good response to conventional treatment. More detailed studies of Evans' syndrome in pregnancy, especially of fetal outcome, are required.
Authors:
Eleftheria Lefkou; Catherine Nelson-Piercy; Beverley J Hunt
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-12-23
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  149     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  10-7     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Haematology, Guy's & St. Thomas' NHS Foundation Trust, London SE1 7EH, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anemia, Hemolytic, Autoimmune / diagnosis,  drug therapy*
Coombs' Test
Female
Humans
Immunoglobulin G / therapeutic use
Prednisolone / therapeutic use
Pregnancy
Pregnancy Complications, Hematologic / diagnosis,  drug therapy*
Pregnancy Outcome
Purpura, Thrombocytopenic, Idiopathic / diagnosis,  drug therapy*
Syndrome
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunoglobulin G; 50-24-8/Prednisolone

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