Early-onset Evans syndrome in a 4-month-old infant: A case report and review of literature

Evans syndrome (ES) is a rare autoimmune disorder characterized by autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP). We report a case of a 4-month old infant who presented with a history of acute pallor and jaundice. She had no family history of any hematological or autoimmune disorders. Her laboratory investigations revealed a positive direct Coombs test with immunoglobulin G autoantibodies, anemia and thrombocytopenia. She was managed initially by blood transfusion and started on high-dose steroid therapy with marked improvement. Very few cases of ES in infants have been reported in the literature. We concluded that this case report may support the possibility of an early-onset ES among infants <6 months of age.