Evan’s syndrome- unusual presentation: a case report


  • Smruti D. Gedam Department of Obstetrics and Gynecology, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Juzar I. Fidvi Department of Obstetrics and Gynecology, Government Medical College and Hospital, Nagpur, Maharashtra, India




Evans syndrome, Anemia with thrombocytopenia, Hemolysis


Evans syndrome is an extremely rare type of autoimmune (hemolytic) disorder due to development of auto-antibodies against own RBCs, platelets and, at-times, neutrophils; most common presentation being mucosal and cutaneous bleeding with varying degree of anemia with thrombocytopenia. The present case is an unusual presentation of Evans syndrome with massive intra-peritoneal bleeding secondary to ruptured ovarian hemorrhagic cyst, which was managed successfully with timely decision of exploratory laparotomy, steroid, immunosuppressant and transfusion with adequate and appropriate blood and blood products. High index of suspicion and multi-disciplinary approach remained the key factors towards a successful outcome and patient went home in good health on 18th post-operative day.


Michel M, Chanet V, Dechartres A, Morin AS, Piette JC, Cirasino L, et al. The spectrum of Evans syndrome in adults: new insight into the disease based on the analysis of 68 cases. Blood. 2009;114(15):3167-72.

Norton A, Roberts I. Management of Evans syndrome. Br J Haematol. 2006;132(2):125-37.

Mathew P, Chen G, Wang W. Evans syndrome: results of a national survey. J Pediatric Hematol/Oncol. 1997;19(5):433-7.

Evans RS, Takahashi K, Duane RT, Payne R, Liu CK. Primary thrombocytopenic purpura and acquired hemolytic anemia: evidence for a common etiology. AMA Arch Int Med. 1951;87(1):48-65.

Audia S, Grienay N, Mounier M, Michel M, Bonnotte B. Evans’ syndrome: from diagnosis to treatment. J Clin Med. 2020;9(12):3851.

Michel M. Adult Evans' Syndrome. Hematol/Oncol Clin. 2022;36(2):381-92.

Miano M. How I manage Evans syndrome and AIHA cases in children. Br J Haematol. 2016;172(4):524-34.






Case Reports