COVID-19 and Mycoplasma Pneumoniae Co-infection Triggering Evans Syndrome; A Case Report

Lau, Chiew Yee; Norman, Najwa Farhana; Mohd Nazri, Muhammad Abubakar Uthman; Md Fauzi, Alina; Mohammad Khuzaini, Aliyyah

doi:10.22038/jpp.2025.89436.5567

COVID-19 and Mycoplasma Pneumoniae Co-infection Triggering Evans Syndrome; A Case Report

Document Type : case report

Authors

Chiew Yee Lau

Najwa Farhana Norman

Muhammad Abubakar Uthman Mohd Nazri

Alina Md Fauzi

Aliyyah Mohammad Khuzaini

Department of Pediatrics, Faculty of Medicine and Health Sciences, University Sains Islam Malaysia, Nilai, Malaysia.

10.22038/jpp.2025.89436.5567

Abstract

Background: Evan’s syndrome (ES) is a rare autoimmune disease characterized by the coexistence of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). The syndrome presents significant clinical challenges due to its diverse and often severe manifestations. The pathology is not well understood, but reports suggest that it may be triggered by infections, autoimmune diseases, hematological malignancies, and primary immunodeficiencies.
Case presentation: We present a case of ES in an 8-year-old child following Coronavirus Disease 2019 (COVID-19) and Mycoplasma pneumoniae infection. Initially, he presented with respiratory distress and symptomatic anemia. Several days later, he developed thrombocytopenia along with symptoms of myocarditis. Therefore, he was diagnosed with ES triggered by infection. Since the initial episode, he has experienced recurrent episodes of AIHA and ITP necessitating oral courses of corticosteroids.
Conclusion: Clinical reports and cohort studies of ES in the pediatric population are crucial to further understand this rare disease and guide management options.

Keywords

Autoimmune cytopenia

Evan syndrome

Hemolytic anemia

hematology

Immune thrombocytopenia

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