Document Type : case report

Authors

• Chiew Yee Lau ¹
• Najwa Farhana Norman ²
• Muhammad Abubakar Uthman Mohd Nazri ²
• Alina Md Fauzi ³
• Aliyyah Mohammad Khuzaini ¹

¹ Paediatric Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia

² Paediatric Unit, Universiti Sains Islam Malaysia (USIM), Fakulti Perubatan dan Sains Kesihatan, Persiaran Ilmu, Putra Nilai, 71800, Malaysia.

³ Pathology Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia.

Abstract

Background

Evan syndrome (ES) is a rare autoimmune disease characterised by coexistence of autoimmune haemolytic anaemia (AIHA) and immune thrombocytopenia (ITP). The syndrome results in significant clinical challenges due to the diverse and often severe manifestations. The pathology is not well understood but reports show that it may be triggered by infections, autoimmune diseases, haematological malignancies and primary immunodeficiencies.



Case report

We report a case of ES in an 8-year-old child following COVID-19 and Mycoplasma pneumoniae infection. He initially presented with respiratory distress and symptomatic anaemia. Several days later, he developed thrombocytopenia when he developed symptoms of myocarditis. Thus, he was diagnosed to have ES triggered by infection. Since the initial episode, he has had recurrent episodes of AIHA and ITP requiring oral courses of corticosteroids.



Conclusion

Clinical reports and cohort studies of ES in the paediatric population are essential to aid further understanding of this rare disease and guide management options.

Keywords

• Evan syndrome
• haemolytic anaemia
• immune thrombocytopenia
• haematology
• autoimmune cytopenia