Evans 증후군과 동반된 경계대뇌경색 1예
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Evans’syndrome is a rare disorder characterized by the presence of Coombs’ positive autoimmune hemolytic anemia and immune thrombocytopenia in the absence of any known underlying causes. The association of cerebral infarction and Evans’syndrome is extremely rare. We report a case of borderzone cerebral infarction associated with Evans’ syndrome. A 31-year old woman with a past history of 3 episodes of spontaneous abortions was admitted because of left hemiparesis. Six months prior to the admission, she had been treated with prednisolone for 2 months with the diagnosis of Evans’ syndrome. Investigation revealed direct and indirect Coombs’ positive hemolytic anemia and thrombocytopenia. Brain MRI revealed right deep white matter and posterior borderzone infarction. Transesophageal echocardiogram and cerebral angiography findings were normal. Although the pathogenesis of cerebral infarction remains unknown, hypercoagulable state and/or microvasculitis may be responsible. Korean Journal of Stroke 2002;4(2):128~131
Abstract
Evans’syndrome is a rare disorder characterized by the presence of Coombs’ positive autoimmune hemolytic anemia and immune thrombocytopenia in the absence of any known underlying causes. The association of cerebral infarction and Evans’syndrome is extremely rare. We report a case of borderzone cerebral infarction associated with Evans’ syndrome. A 31-year old woman with a past history of 3 episodes of spontaneous abortions was admitted because of left hemiparesis. Six months prior to the admission, she had been treated with prednisolone for 2 months with the diagnosis of Evans’ syndrome. Investigation revealed direct and indirect Coombs’ positive hemolytic anemia and thrombocytopenia. Brain MRI revealed right deep white matter and posterior borderzone infarction. Transesophageal echocardiogram and cerebral angiography findings were normal. Although the pathogenesis of cerebral infarction remains unknown, hypercoagulable state and/or microvasculitis may be responsible. Korean Journal of Stroke 2002;4(2):128~131