Evans Syndrome: A Case Report

Motij Dalai, Deepak S, Emmanuel Paul

Abstract: Introduction: Evans syndrome (ES) is a rare and chronic autoimmune disease defined as simultaneous or sequential the presence of direct Coombs-positive autoimmune haemolytic anemia (AIHA) in conjunction with immune-mediated thrombocytopenia. Case report: In this case report we are reporting a 25 years old unmarried female with complaints of easy fatigability, shortness of breath and petechial rashes over her trunk which gradually over period of 1 month spread over to other parts of the body associated with gum bleeding and menorrhagia for 15 days. Laboratory evaluations were suggestive of AIHA and ITP. She was treated with PRBC, platelet transfusion and steroids and she was improved. Discussion: The typical course of ES is characterized by a heterogeneous chronic disease with clinical variability at onset, spontaneous remissions and exacerbations. Most of the cases of ES presents primarily with severe AIHA and mild thrombocytopenia. Steroids, other immunosuppressive agents and supportive therapy remain the mainstay of treatment. Conclusion: Evans syndrome is a rare clinical entity. High degree of clinical suspicion from the beginning is essential for better patient outcome.

Keywords: Evans syndrome, ITP, AIHA