EVANSS-SYNDROME WITH POSITIVE LUPUS ANTICOAGULANT AND ANTIPHOSPHOLIPID-PROTEIN ANTIBODIES

We report a case of a 34-year-oId Caucasian man with Evans's syndrome, first manifested in childhood as autoimmune thrombocytopenia. Besides antierythrocyte antibodies and platelet-associated immunoglobulins, t his patient's serum showed also the presence of antiphospholipid-prote in antibodies detected by coagulometric (lupus anticoagulant) as well as immunoenzymatic methods (anticardiolipin, antiprothrombin, and anti -beta(2)-glycoprotein I antibodies). Over 25 years of clinical observa tion the patient never experienced any thromboembolic events. We sugge st that in the pathogenesis of Evans's syndrome and related disorders a major role is played by an autoimmune reaction with a predilection t o various cell phospholipid-containing membrane structures, possibly d amaged by a yet unknown primary insult. The significance of these vari ous antiphospholipid-protein antibodies as predictors of thromboemboli c complications in such patients remains, however, to be established.