title: Multiple myeloma associated with an Evan's syndrome.
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.
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Achour
authors.initials: A
authors.lastname: Bechir
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Regaieg
authors.initials: R
authors.lastname: Haifa
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Ben Sayed
authors.initials: BS
authors.lastname: Nesrine
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Bouslema
authors.initials: B
authors.lastname: Emna
authors.affiliation: Department of Radiology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Mejdoub
authors.initials: M
authors.lastname: Senda
authors.affiliation: Department of Radiology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Achour
authors.initials: A
authors.lastname: Asma
authors.affiliation: Laboratory of biologic Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Bouatay Bouzouita
authors.initials: BB
authors.lastname: Amina
authors.affiliation: Departement of Nephrology, Sahloul Hospital, Sousse Tunisia.
authors.forename: Senda
authors.initials: S
authors.lastname: Mrabet
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Ben Youssef
authors.initials: BY
authors.lastname: Yosra
authors.affiliation: Laboratory of biologic Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Kortas
authors.initials: K
authors.lastname: Mondher
authors.affiliation: Department of Hematology, Farhat Hached Hospital, Sousse Tunisia.
authors.forename: Khelif
authors.initials: K
authors.lastname: Abderrahim
mesh_terms: D000140:Acidosis, Lactic / Q000503:physiopathology; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis* / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001323:Autoantibodies / Q000276:immunology; D000069286:Bortezomib / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013792:Thalidomide / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000276:immunology
chemical_list: D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone
keywords: Multiple myeloma; autoimmun hemolytic anemia; evan´s syndrome; thrombocytopenia