Evans syndrome (patient information)
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Evans syndrome |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Overview
Symptoms of Evans syndrome include breathlessness, fatigue, jaundice and dark urine. Laboratory findings consistent with the diagnosis of Evans syndrome include anemia, direct coombs test positive, and antineutrophil antibody positive. Evans syndrome must be differentiated from acquired thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, Kasabach-Merritt syndrome, fibromatosis, fibrosarcoma, myxofibrosarcoma, nodular fasciitis and myxoid neurofibroma. Pharmacologic medical therapies for Evans syndrome include prednisone, intravenous immunoglobulin, and rituximab.
What are the symptoms of Evans syndrome?
Symptoms of carriers are as follows:
- Breathlessness
- Feeling faint
- Shooting pains
- Faster heart rate
- Malaise
- Ulcers from mucous membrane
In autoimmune hemolytic anemia the following may be found:
- Fatigue
- Pale skin color
- Shortness of breath
- Rapid heartbeat
- Jaundice colored skin
- Yellow/jaundice colored eyes
- Dark urine
Diagnosis
- The diagnosis of Evan’s Syndrome is based primarily on laboratory findings, as well as the corresponding physical signs and symptoms.
- A complete blood count (CBC) will confirm the presence of anemia and low platelets.
- Peripheral smear - A peripheral smear of the blood may reveal evidence of red blood cell destruction or reticulocytosis. Reticulocytes are immature red blood cells and are usually abundant in Evan’s syndrome where there is a need to replace ongoing losses. There are also distinct shapes to certain cells that may be found when a sample of the patient’s blood is viewed under a microscope. In patients with Evan’s syndrome the red blood cells may appear small and globular shaped (then called spherocytes) but will not be fragmented.
- A Coombs test is used to detect the presence of antibodies against the RBC and is usually positive in immune mediated hemolysis.
- Other antibodies may occur directed against neutrophils and lymphocytes,[1]
Diseases with similar symptoms
Evans syndrome must be differentiated from acquired thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, Kasabach-Merritt syndrome, fibromatosis, fibrosarcoma, myxofibrosarcoma, nodular fasciitis and myxoid neurofibroma.
When to seek urgent medical care?
Call your health care provider if symptoms of Evans syndrome develop.
Treatment options
Pharmacologic medical therapies for Evans syndrome include prednisone, intravenous immunoglobulin, and rituximab. Surgery is not the firstline treatment option for patients with Evans syndrome. Splenectomy is usually reserved for patients who are unresponsive to treatment.
Where to find medical care for Evans syndrome?
Directions to Hospitals Treating Evans syndrome
Sources
http://wrongdiagnosis.com/cosymptoms/evans-syndrome.htm
Reference
- ↑ Pegels JG, Helmerhorst FM, van Leeuwen EF, van de Plas-van Dalen C, Engelfriet CP, von dem Borne AE (1982). "The Evans syndrome: characterization of the responsible autoantibodies". Br. J. Haematol. 51 (3): 445–50. doi:10.1111/j.1365-2141.1982.tb02801.x. PMID 7104228.