Evans Syndrome and pregnancy: A case report with literature review

Evans syndrome is a rare autoimmune disease in which an individual's antibodies attacks the body's own red blood cells and platelets.1 There is a coexistence of Immune thrombocytopenia (ITP) with Autoimmune haemolytic anaemia (AIHA) and both of these events may occur simultaneously or one follows the other. 2 Association of Evans syndrome with pregnancy is very rare, and only a few cases have been published in medical literature. No definite treatment protocols are defined. Treatment options during pregnancy are further limited due to concerns of teratogenic effect of pharmacological agents. 3 Evans syndrome can be diagnosed with a full blood count film and a Coombs test. We describe here a rare case that was diagnosed as Evans syndrome during pregnancy that resulted in birth of stillborn twins after the case became complicated with the onset of Eclampsia. We have also briefly discussed the pathophysiology, the possible treatment options during pregnancy and prenatal outcome of Evans syndrome. This case was presented in June 2015 at the outpatient department of Obstetrics & Gynecology in Nishtar Medical College and Hospital, Multan.