title: Simultaneous romiplostin, eltrombopag, and prednisone were successful in severe thrombocytopenia of Evans syndrome refractory to hydrocortisone, splenectomy, intravenous IgG, and rituximab.
abstract: A 58-year-old woman presented with rheumatoid arthritis-associated Evans syndrome (simultaneous autoimmune hemolytic anemia and autoimmune thrombocytopenic purpura); she was treated unsuccessfully with steroids, romiplostin, rituximab, immunoglobulin G, and splenectomy. The platelet count responded to the combined use of prednisone, eltrombopag, and romiplostin. It may be more reasonable to use combined treatments than sequential monotherapies.
authors: Clinica Ruiz, Puebla, Mexico. gruizl@clinicaruiz.com
authors: Guillermo José
authors: GJ
authors: Ruiz-Arguelles
authors: Guillermo José
authors: GJ
authors: Ruiz-Delgado
authors: Sara
authors: S
authors: Velázquez-Sánchez-de-Cima
authors: Gabriela
authors: G
authors: Zamora-Ortiz
mesh_terms: D000208:Acute Disease; D000744:Anemia, Hemolytic, Autoimmune / Q000473:pathology / Q000628:therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006834:Hydrazines / Q000627:therapeutic use*; D006854:Hydrocortisone / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D011720:Pyrazoles / Q000627:therapeutic use*; D011961:Receptors, Fc / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D000069283:Rituximab; D013156:Splenectomy; D013921:Thrombocytopenia / Q000473:pathology / Q000628:therapy*; D013926:Thrombopoietin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001565:Benzoates; D004338:Drug Combinations; D006834:Hydrazines; D016756:Immunoglobulins, Intravenous; D011720:Pyrazoles; D011961:Receptors, Fc; D011993:Recombinant Fusion Proteins; D000069283:Rituximab; D013926:Thrombopoietin; C488777:romiplostim; C520809:eltrombopag; D011241:Prednisone; D006854:Hydrocortisone