A Case of Pregnancy Complicated with Evans Syndrome with Sequential Development of Autoimmune Warm Antibody Hemolytic Anemia and Idiopathic Thrombocytopenic Purpura

Table 1

Blood test results (reference ranges are shown).

(a) Total blood count and urine test data when anemia developed at 28 weeks of gestation

WBC	8.2 x10^3	(4.0-9.0 x10^3)	/ul
RBC	2.73 x10^6	(3.80-4.80 x 10^6)	/ul
Hb	7.9	(11.0-15.0)	g/dl
PLT	19.7 x 10^4	(12-35 x 10^4)	/ul
MCV	108.1	(83.0-99.0)	fl
MCH	35.3	(28.4-34.6)	pg
Reticulocyte	20 x 10^4	(3-10 x 10^4)	/ul
	73.4	(5.0-20.0)
Urine hemoglobin	negative

(b) Detailed blood test results at 29 weeks of gestation

AST	17	(8-30)	IU/l
ALT	10	(5-35)	IU/l
Creatinine	0.51	(0.30-0.90)	mg/dl
LDH	312	(106-211)	IU/l
LDH 1	40	(21-31)	%
LDH 2	37	(28-35)	%
LDH 3	15	(21-26)	%
LDH 4	4	(7-14)	%
LDH 5	4	(5-13)	%
UA	4.3	(2.5-7.0)	mg/dl
Total Bilirubin	0.8	(0.2-1.0)	mg/dl
C3	100	(65-135)	mg/dl
C4	29	(13-35)	mg/dl
Antinuclear antibody	negative
Fe	100	(55-180)	ug/dl
Ferritin	40.3	(5-152)	ng/ml
UIBC	290	(130-320)	ug/dl
Haptoglobin	10>		mg/dl
Direct Coombs	positive
Indirect Coombs	negative
IgG	757	(870-1700)	mg/dl
IgA	160	(100-410)	mg/dl
IgM	70	(35-220)	mg/dl
Cold agglutinin reaction	128	(<256)	titer