Multiple myeloma associated with an Evan's syndrome

Pan Afr Med J. 2016 Nov 1:25:127. doi: 10.11604/pamj.2016.25.127.10750. eCollection 2016.

Abstract

Auto-immun events are rare in multiple myeloma (MM). Here, we report one MM case complicated by Evans syndrome (Autoimmun hemolytic anemia (AIHA) associated with thrombocytopenia). A 52-year-old man was admitted in nephrology department with severe anemia, renal insufficiency and hypergamma globulinemia. Laboratory exams showed acute hemolysis due to an IgG warm autoantibody. Serum electrophoresis revealed the presence of a monoclonal IgG protein and urinary M protein was 2g/day. A whole body CT-Scan showed osteolytic lesions of vertebral body of C5, D4, L3, L4 and the left iliac wing. The diagnosis of multiple myeloma and Evan's syndrome was made, we underwent chemotherapy by BTD (bortezomib-thalidomide-dexamethasone) and continuous corticosteroid therapy but unfortunately the patient died secondary of a Lactic acidosis. The relationship between MM and hemolysis remain unclear.

Keywords: Multiple myeloma; autoimmun hemolytic anemia; evan´s syndrome; thrombocytopenia.

Publication types

  • Case Reports

MeSH terms

  • Acidosis, Lactic / physiopathology
  • Adrenal Cortex Hormones / administration & dosage
  • Anemia, Hemolytic, Autoimmune / diagnosis*
  • Anemia, Hemolytic, Autoimmune / immunology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Autoantibodies / immunology
  • Bortezomib / administration & dosage
  • Dexamethasone / administration & dosage
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Multiple Myeloma / diagnosis*
  • Multiple Myeloma / drug therapy
  • Multiple Myeloma / pathology
  • Thalidomide / administration & dosage
  • Thrombocytopenia / diagnosis*
  • Thrombocytopenia / immunology

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Thalidomide
  • Bortezomib
  • Dexamethasone

Supplementary concepts

  • Evans Syndrome