Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

Takashi Ushiki; Masayoshi Masuko; Koji Nikkuni; Jun Terukina-Yoshida; Ayako Momotsu-Nanba; Hiroshi Morikawa; Akio Usami; Ichiro Fuse; Ken Toba; Kazue Takai; Yoshifusa Aizawa

doi:10.2169/internalmedicine.50.4319

CASE REPORTS

Successful Remission of Evans Syndrome Associated with Graves' Disease by Using Propylthiouracil Monotherapy

Takashi Ushiki, Masayoshi Masuko, Koji Nikkuni, Jun Terukina-Yoshida, Ayako Momotsu-Nanba, Hiroshi Morikawa, Akio Usami, Ichiro Fuse, Ken Toba, Kazue Takai, Yoshifusa Aizawa

Author information

Takashi Ushiki
Department of Hematology, Niigata University Graduate School of Medical and Dental Sciences, Japan
Department of Hematology, Niigata City General Hospital, Japan
Masayoshi Masuko
Department of Stem Cell Transplantation, Niigata University Medical and Dental General Hospital, Japan
Koji Nikkuni
Department of Hematology, Niigata City General Hospital, Japan
Jun Terukina-Yoshida
Department of Hematology, Niigata City General Hospital, Japan
Ayako Momotsu-Nanba
Department of Hematology, Niigata City General Hospital, Japan
Hiroshi Morikawa
Department of Endocrinology, Niigata City General Hospital, Japan
Akio Usami
Usami Clinic, Japan
Ichiro Fuse
Bioscience Medical Research Center, Niigata University Medical and Dental General Hospital, Japan
Ken Toba
Department of Hematology, Niigata University Graduate School of Medical and Dental Sciences, Japan
Kazue Takai
Department of Hematology, Niigata City General Hospital, Japan
Yoshifusa Aizawa
Department of Hematology, Niigata University Graduate School of Medical and Dental Sciences, Japan

Keywords: Evans syndrome, Graves' disease, soluble IL-2 receptor, propylthiouracil

JOURNAL OPEN ACCESS

2011 Volume 50 Issue 6 Pages 621-625

DOI https://doi.org/10.2169/internalmedicine.50.4319

Details

Abstract

A 46-year-old woman with Graves' disease was admitted for anemia and thrombocytopenia. She had previously been treated with methimazole but she self-discontinued the treatment 6 months prior to admission. She was diagnosed with Evans syndrome associated with Graves' disease and treated with propylthiouracil without corticosteroids, which normalized her thyroglobulin level. Surprisingly, while Evans syndrome is characterized by frequent relapses, this patient has been in remission of Evans syndrome for approximately 4 years. The remission of Evans syndrome associated with Graves' disease in the absence of immunosuppressive therapy suggests that these 2 diseases have a common pathogenetic mechanism.

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