Stroke in evan syndrome

Abstract

Evans syndrome is a rare autoimmune disorder with unknown etiology, characterized as a combination of either concurrent or sequential from Autoimmune Hemolitic Anemias (AIHA) and Idiopathic Trombocytopenias Purpura (ITP). Stroke is a complication that often occurs in evans syndrome. We report a 25-year-old woman, pregnant 5 weeks, complained disartria and facial drop. The patient has been diagnosed with evans syndrome 5 years ago and has a history of deep vein thrombosis (DVT) 2 years ago. On examination of the patient's condition, compos mentis, blood pressure 128 / 70mmHg, pulse 103x / minute. Neurological examination found parese of VII and XII cranial nerve, Barthel index is 70 and NIHSS is 3. Laboratory results of blood hemoglobin 7.8 gm / dl, 1.780 mg / dl leukocytes, 64.6% neutrophils, 22.5% lymphocytes, and 6.7% eosinophils. 47,000 platelets / cu.mm. The peripheral blood morphology examination is pancytopenia with an overview of anemia et causa suspected hemolytic processes. Rheumatoid and specific protein immunological examination. ACA IgG > 200 (elevated > 10), ACA IgM 2.2 (eleveted > 7), β2-GP1 IgM 2 (elevated > 8), β2-GP1 IgG > 100 (elevated > 8). ANA test 0.651. Head CT scan examination is the cerebral infarction in the frontal frontal lobe. An ultrasound examination of the dopler on the left leg showed results deep vein thrombosis. The patient was treated with anticoagulant and immunosuppressive. This case report privides an overview of the association between Evan syndrome and stroke