Intravenous immunoglobulins as pre-operative management in a case of hereditary spherocytosis

Complications of Evans' syndrome in an infant with hereditary spherocytosis: a case report

Hereditary spherocytosis (HS) is a genetic disorder of the red blood cell membrane clinically characterized by anemia, jaundice and splenomegaly. Evans' syndrome is a clinical syndrome characterized by autoimmune hemolytic anemia (AIHA) accompanied by immune thrombocytopenic purpura (ITP). It results from a malfunction of the immune system that produces multiple autoantibodies targeting at least red blood cells and platelets. HS and Evans' syndrome have different mechanisms of pathophysiology one another. We reported the quite rare case of an infant who had these diseases concurrently. Possible explanations of the unexpected complication are discussed.

Effect of corticosteroids in hereditary spherocytosis

Prednisolone was administered to three children with hereditary spherocytosis. At the time corticosteroid therapy was started, two of the patients were suffering from severe hemolytic anemia and the 3rd patient had partially recovered from hemolytic anemia after splenectomy. All of the patients prednisolone produced a remarkable increase in the hemoglobin levels with a concomitant increase in reticulocyte counts. We conclude that corticosteroids might stimulate erythropoiesis and may be an alternative therapy to red cell transfusion in pre-operative states for patients with hereditary spherocytosis.