Recurrent and Refractory Ischemic Stroke Complicating Evans Syndrome

Jong Wook Shin, Hyun-Wook Nah and Hee-Jung Song*

Department of Neurology, Chungnam National University College of Medicine and Sejong Hospital, Korea

^*Correspondance to: Hee-Jung Song 

 PDF  Full Text DOI: 10.25107/2474-1647.3066

Abstract

Evans Syndrome (ES) is characterized by autoimmune hemolytic anemia and immune thrombocytopenia. ES rarely manifests thromboembolic events of the Central Nervous System (CNS), especially cerebral infarction. We experienced a 72-year-old woman with ES accompanied by recurrent and refractory cerebral infarction. Laboratory studies showed anemia with positive Coombs test and thrombocytopenia. Lupus and other rheumatologic studies were normal. Magnetic Resonance Imaging (MRI) of the brain depicted acute cerebral infarction in the right MCA territory. Abnormal laboratory profiles normalized with the administration of prednisone. However, cerebral infarction recurred twice in both MCA territory despite the stabilization of ES. Transthoracic and trans-esophageal echocardiography showed no abnormality. Hypercoagulability, which is one of the most precipitating factors of stroke, may attribute to the pathomechanism of the cerebral infarction in Evans?s syndrome.

Keywords

Evans syndrome; Autoimmune hemolytic anemia; Recurrent cerebral infarction; stroke

Cite the article

Shin JW, Nah H-W, Song H-J. Recurrent and Refractory Ischemic Stroke Complicating Evans Syndrome. Clin Surg. 2021; 6: 3066.