[Evans' syndrome caused by D-penicillamine in rheumatoid arthritis. Value of the corticoids-danazol combination]

Rev Rhum Mal Osteoartic. 1991 Jul-Sep;58(7):519-22.
[Article in French]

Abstract

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.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Anemia, Hemolytic, Autoimmune / chemically induced*
  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Arthritis, Rheumatoid / drug therapy*
  • Danazol / therapeutic use
  • Drug Therapy, Combination
  • Humans
  • Hydrocortisone / therapeutic use
  • Male
  • Middle Aged
  • Penicillamine / adverse effects*
  • Penicillamine / therapeutic use
  • Prednisolone / therapeutic use
  • Purpura, Thrombocytopenic / chemically induced*
  • Purpura, Thrombocytopenic / drug therapy
  • Syndrome
  • Time Factors

Substances

  • Prednisolone
  • Penicillamine
  • Danazol
  • Hydrocortisone