 idiopath autoimmun hemolyt anemia idiopath thrombocytopen purpura associ diffus hypergammaglobulinemia amyloidosi hypoalbuminemia plasmacytosi case report sixti-nine year woman sever idiopath autoimmun hemolyt anemia initi control splenectomi relaps associ develop sever autoimmun thrombocytopen purpura fail respond larg dose prednison control variabl degre imuran associ featur includ diffus hypergammaglobulinemia excess gamma-u protein urin idiopath hypoalbuminemia greatli reduc total exchang albumin pool amyloidosi spleen organ diffus plasmacytosi bone marrow lymph node thorac periton fat featur interrelationship discuss defici synthesi specif neutral antibodi virus indic qualit immun defici exist frequenc occurr thrombocytopen purpura case discuss prognosi mechan action antimetabolit induc remiss autoimmun hemolyt anemia well etiolog diseas review 