Refractory Evans syndrome complicated with transverse sinus thrombosis

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  • HAGIHARA Masao
    Depertment of Internal Medicine, Ebina General Hospital Depertment of Hematology and Rheumatology, Tokai University
  • WATANABE Shigeki
    Depertment of Internal Medicine, Ebina General Hospital Depertment of Hematology and Rheumatology, Tokai University
  • TSUBOI Kosuke
    Depertment of Internal Medicine, Ebina General Hospital Depertment of Hematology and Rheumatology, Tokai University
  • SUYAMA Takahiro
    Depertment of Internal Medicine, Ebina General Hospital
  • SATO Koji
    Depertment of Internal Medicine, Ebina General Hospital Depertment of Hematology and Rheumatology, Tokai University

Bibliographic Information

Other Title
  • 脳横静脈洞血栓症を合併した難治性Evans症候群
  • 症例 脳横静脈洞血栓症を合併した難治性Evans症候群
  • ショウレイ ノウ オウ ジョウミャクドウ ケッセンショウ オ ガッペイ シタ ナンジセイ Evans ショウコウグン

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Description

A 29-year-old woman was diagnosed as having Evans syndrome in 2002 and underwent a splenectomy for the refractory status of the disorder in May 2004. One and a half months after the operation, her platelet count again decreased due to relapse, and she was then prescribed with high dose dexamethasone (38 mg/day×4 days). Five days after the medication, she complained of a severe headache and then fell into coma, even though her platelet count had risen to 8×104/mm3. Computer tomography scan of the brain showed severe edema with a massive hemorrhage in left temporooccipital lobe, which was compatible with cerebral transverse sinus thrombosis. After resection of the damaged brain, her level of consciousness gradually recovered, although visual disturbance and moderate hemiplegia remained. This is the fourth case of idiopathic thrombocytopenic purpura which was complicated with sinus thrombosis in the literature.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 46 (7), 513-516, 2005

    The Japanese Society of Hematology

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