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Early-onset Evans Syndrome in a 4-Month-Old Infant: A Case Report and Review of Literature

Khaled Kamaleddin Mohamed1, Faisal Othman Al-Qurashi1, Mohammad Hussain Al-Qahtani1

  • 1Department of Pediatrics, King Fahd Hospital of the University, University of Dammam, Dammam, Saudi Arabia.

Saudi Journal of Medicine & Medical Sciences
|February 22, 2019
PubMed

Insights

Evans syndrome (ES), a rare autoimmune disorder, involves autoimmune hemolytic anemia and immune thrombocytopenic purpura. This case report highlights early-onset ES in an infant, suggesting it can occur before six months of age.

Area of Science:

  • Pediatrics
  • Hematology
  • Immunology

Background:

  • Evans syndrome (ES) is a rare autoimmune condition.
  • It is characterized by concurrent autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP).
  • ES is seldom reported in infants, particularly those under six months.

Observation:

  • A 4-month-old infant presented with acute pallor and jaundice.
  • The infant had no prior family history of hematological or autoimmune diseases.
  • Investigations confirmed anemia, thrombocytopenia, and a positive direct Coombs test with IgG autoantibodies.

Findings:

  • The infant was treated with blood transfusion and high-dose steroids.
  • The patient showed significant clinical improvement following treatment.
  • This case suggests ES can manifest in early infancy.

Implications:

  • This case supports the potential for early-onset Evans syndrome in infants younger than six months.
  • Early diagnosis and management are crucial for favorable outcomes in pediatric ES.
  • Further research into the incidence and presentation of ES in infants is warranted.

Keywords:
Autoimmune hemolytic anemiaEvans syndromecorticosteroidsimmune thrombocytopenic purpurainfantsrare diseases

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