Síndrome de evans y embarazo en la adolescencia: Reporte de un caso y revisión de la literatura

Abstract

Objective: To present the case of a pregnant teenage girl with Evans Syndrome, and to conduct a review of the literature regarding treatment and prognosis during pregnancy. Materials and methods: Case presentation of a pregnant teenage girl with Evans Syndrome managed at our unit in a Level II referral hospital in Bogota, Colombia; description of the clinical history, diagnosis, management and outcome; and review of the literature focusing on treatment and prognosis. A search of the literature was conducted using the Medline database through PubMed, EMBASE and the Cochrane library up to May 2016. The key terms used were "autoimmune haemolytic anaemia", "thrombocytopenia", "Evans Syndrome" and "pregnancy", both in Spanish and English, with no restriction by year of publication. Results: Overall, 79 publications were found in Medline and 61 in EMBASE. Of these, 13 studies related directly to the topic, one was a systematic review of the literature, and the rest were case reports. All the case reports found are included in the systematic review. Evans Syndrome must be suspected when there is thrombocytopenia and haemolysis in the pregnant woman. The course of the disease varies during pregnancy and warrants close maternal and foetal follow-up. Treatment options are available, including steroids, intravenous gamma globulin and, in certain cases, surgical management with splenectomy. Conclusions: Evans Syndrome is a rare disease during pregnancy. Further studies are needed regarding the treatment and prognosis of the disease in order to guide treatment.