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Evans syndrome is an uncommon condition defined as the combination (either simultaneously or sequentially) of immune thrombocytopenia (ITP) and autoimmune haemolytic anaemia (AIHA) with a positive direct antiglobulin test (DAT) in the absence of known underlying aetiology. It poses great diagnostic dilemma due to its variable presentation. We present a case of a 56-year-old female who had similar difficulty as it was not diagnosed initially when she presented with anaemia and thrombocytopenia and was treated by packed cell transfusion and platelet concentrate transfusion respectively. However, the patient showed repeated thrombocytopenia and low a haemoglobin and referred to us and diagnostic work-up confirmed Evans's; syndrome. This case stresses on the diagnostic importance of peripheral blood picture, reticulocyte count and direct antiglobulin test in every patient presenting with anaemia and / or thrombocytopenia to rule out haemolytic anaemia and thrombocytopenia of autoimmune etiology and thus help in arriving at right diagnosis.

Evans' syndrome- haemolytic anaemia with thrombocytopenia - a rare autoimmune disorder