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Revista Mexicana de Anestesiología

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2022, Number 2

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Rev Mex Anest 2022; 45 (2)

Laparoscopic splenectomy in patient with Evans syndrome

Bendaña JE, Salinas-Vallecillo LC
Full text How to cite this article 10.35366/103889

DOI

DOI: 10.35366/103889
URL: https://dx.doi.org/10.35366/103889

Language: Spanish
References: 13
Page: 135-137
PDF size: 181.87 Kb.


Key words:

Evans syndrome, splenectomy, thrombocytopenia.

ABSTRACT

Evans syndrome is a rare syndrome that occurs in approximately 3.6 per million inhabitants; being more common in women. Its characteristics are the presence of idiopathic autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura. We present a case of a 42-year-old patient with no improvement in her platelet level, so it was programmed to perform a laparoscopic splenectomy. The patient before the surgical intervention presented a level of platelets considered limit, 53,000/μL, so it was decided to transfuse platelets before surgery. During the pre-anesthesia evaluation, multiple risk factors were recorded to be considered as a difficult airways. Thrombocytopenia was improved and perioperative steroids were maintained. It was decided to administer general endotracheal anesthesia, obtaining satisfactory anesthesia during the surgical procedure.


REFERENCES

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  2. Al Hazmi A, Winters M. Evans Syndrome. Clinical Practice and Cases in Emergency Medicine. 2019;2:128-131.

  3. Jaime-Perez JC, Aguilar-Calderon P, Cavazos L, et al. Evans Syndrome: clinical perspectives, biological insights and treatment modalities. Journal of Blood Medicine. 2018;9:171-184.

  4. Jaime-Perez JC, Guerra-Leal LN, Lopez-Razo ON, et al. Experience with Evans Syndrome in an academic referral center. Brazilian Journal of Hematology and Hemotherapy. 2015;37:230-235.

  5. Monga V, Maliske S, Perepu U. Fatal pulmonary embolism following splenectomy in a patient with Evans syndrome: case report and review of the literature. Thrombosis Journal. 2017;15:1-10.

  6. Bonnet S, Guedon A, Ribeil J-A, et al. Indications and outcomes of splenectomy in hematologic diseases. Journal of Visceral Surgery. 2017;154:421-429.

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  8. Houwerzijl EJ, Louwes H, Sluiter WJ, et al. Platelet production rate predicts the response to prednisone therapy in patients with idiopathic thrombocytopenic purpura. Ann Hematol. 2008;87:975-983.

  9. Liu, Dora et al. A practical guide to the monitoring and management of the complications of systemic corticosteroid therapy. Allergy, asthma, and clinical immunology. 2013;9:1-30.

  10. Jonnavithula N, Pasupulenti S, Thumma V, et al. Anesthetic management of laparoscopic splenectomy in a case of Evans syndrome with systemic lupus erythematosis. Journal of Anesthesiology Clinical Pharmacology. 2018;34:263-264.

  11. Duperier T, Felsher J, Brody F. Laparoscopic splenectomy for Evans syndrome. Surgical Laparoscopy Endoscopy Percutaneous Techniques. 2003;13:45-47.

  12. Gupta S, Kalayarsen R, Chandrasekar S, et al. Laparoscopic Splenectomy for Inmune Thrombocytopenic Purpura (ITP) Patients with Very Severe Thrombocytopenia. Indian Journal of Hematology and Blood Transfusion. 2018;34:535-539.

  13. Weledji EP. Benefits and risks of splenectomy. International Journal of Surgery. 2014;12:113-9.




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Rev Mex Anest. 2022;45