Evans syndrome and Graves' Disease: An unusual presentation – A case report

Abstract

Introduction: Evans syndrome (ES), an infrequently encountered haematological condition, is characterized by coombs-positive autoimmune hemolytic anaemia (AIHA) in association with immune thrombocytopenia (ITP). The association of ES with Graves' disease (GD) is rare, this being probably the first case reported from the Indian subcontinent. Methods: We present the case of a 32-year-old woman diagnosed with AIHA in 2017 and ITP with GD during the current hospitalization. Results: The patient was initiated on immunosuppressive therapy with azathioprine and thiamazole, following which she entered remission. Conclusion: The pathophysiology of ES with Graves' disease seems to encompass hyperthyroidism and autoimmunity. To date, there are no well-defined guidelines for its treatment. Efforts should be made to devise standardized treatment options.

Keywords

• autoimmune hemolytic anemia
• evans syndrome
• graves' disease
• immune thrombocytopenia