Evans Syndrome in a Forty-Four Years Old Male Patient: A Case Report

Authors

  • Rudy Afriant Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
  • Avino Mulana Fikri Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
  • Alexander Kam Division of Endocrine Metabolic and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia

DOI:

https://doi.org/10.37275/bsm.v7i4.805

Keywords:

Autoimmune disease, Evans syndrome, Hemolytic anemia, Idiopathic thrombocytopenic purpura

Abstract

Background: Evans syndrome (ES) is an autoimmune disease characterized by the presence of autoimmune hemolytic anemia (AIHA) and idiopathic thrombocytopenic purpura (ITP), together with unknown causes. ES disease is the least common, diagnosed in only 0.8% - 3.7% of all patients with AIHA or ITP. This study aimed to describe Evans syndrome in a 44-year-old male patient.

Case presentation: A 44-year-old male patient was reported with complaints of weakness and fatigue, red spots, a history of bleeding gums, a history of bleeding from the nose, and a history of red urination. A routine blood examination revealed mild anemia, reticulocytosis, and thrombocytopenia, and the peripheral blood showed polychromatic erythrocytes. Other laboratory examinations revealed an increase in LDH. The results of a positive Comb’s test and antibody screening examination showed the impression of warm-type AIHA. The diagnosis of Evans syndrome in this patient was confirmed by the presence of AIHA and ITP, which co-occur and are primarily due to unknown causes.

Conclusion: ES is a rare disorder and a diagnosis of exclusion. The diagnosis of ES was established by the presence of signs and symptoms of AIHA and ITP accompanied by a positive direct antiglobulin test with no other etiology found.

Authors

  • Rudy Afriant1*
  • Avino Mulana Fikri2
  • Alexander Kam3
  1. 1Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
  2. 2Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
  3. 3Division of Endocrine Metabolic and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia

Corresponding author Rudy Afriant — rudyafriant@med.unand.ac.id

Article history

  1. Submitted
  2. Accepted
  3. Published

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Published

2023-05-22

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How to Cite

1.
Afriant R, Fikri AM, Kam A. Evans Syndrome in a Forty-Four Years Old Male Patient: A Case Report. Bioscmed [Internet]. 2023 May 22 [cited 2026 Aug. 16];7(4):3226-9. Available from: https://bioscmed.com/index.php/bsm/article/view/805

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