[Favorable response to vinblastine in an idiopathic case of Evans Syndrome]. / Respuesta favorable a vinblastina en un caso idiopático de Síndrome de Evans.

Evan's Syndrome (ES) may develop in isolation or associated to other autoimmune diseases, solid tumors and lymphoproliferative syndromes. This type of processes can be refractory to the usual medication, that is, to corticoids and splenectomy. High doses of Immunoglobulins (polyvalent IgG) and immunosuppressive drugs are therapeutical alternatives that have been used with different results. We present a case of idiopathic ES refractory to high doses of corticoids and IgG, showing complete remission after the administration of two infusions of vinblastin. We believe that vinblastin is a very useful therapeutical alternative in the cases of ES refractory to the usual treatment.

Hemophagocytic syndrome causing complete bone marrow failure. Report of an extreme case of a reactive histiocytic disorder.

The hemophagocytic syndrome is a reactive disorder of the mononuclear phagocytic system. Most of the cases are rare complications of common infectious and neoplastic diseases, although there may be an underlying immune disorder predisposing to this syndrome. We report a case in association with immune thrombocytopenia and hemolytic anemia (Evans' syndrome). The hemophagocytic reaction appeared after a bacterial infection of the urinary tract and presented with abrupt pancytopenia and complete hemopoietic failure. We discuss the possible mechanisms of bone marrow failure related with the hemophagocytic syndrome.