[Evans' syndrome caused by D-penicillamine in rheumatoid arthritis. Value of the corticoids-danazol combination].
The authors report the development of thrombocytopenia purpura in one patient with seropositive and erosive rheumatoid arthritis treated successfully for 11 months with D-penicillamine. Anti-platelet-bound antibodies were present, but also: anti-erythrocyte antibodies with hemolytic anemia (then defining Evans's syndrome): higher level of antinuclear antibodies; intermittent neutropenia. The responsibility of D-penicillamine is discussed, but thrombocytopenia purpura evolved for itself. Glucocorticoids alone, intravenous immunoglobulin, vincristine did not induced remission, which at least occurred under the association danazol-glucocorticoids, without toxicity, especially on the liver function.
Service de Rhumatologie, CHRU Angers.
C
C
Masson
C
C
Brégeon
N
N
Ifrah
V
V
Berton
F
F
Housseau
J C
JC
Rénier
D000744:Anemia, Hemolytic, Autoimmune / Q000139:chemically induced* / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D003613:Danazol / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010396:Penicillamine / Q000009:adverse effects* / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011696:Purpura, Thrombocytopenic / Q000139:chemically induced* / Q000188:drug therapy; D013577:Syndrome; D013997:Time Factors
D011239:Prednisolone; D010396:Penicillamine; D003613:Danazol; D006854:Hydrocortisone
Syndrome d'Evans sous D-pénicillamine au cours d'une polyarthrite rhumatoïde. Intérêt de l'association corticoïdes-danazol.