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Case Reports
. 2019 Feb 26;3(2):128-131.
doi: 10.5811/cpcem.2019.1.41028. eCollection 2019 May.

Evans Syndrome

Ahmed Al Hazmi  1 , Michael E Winters  2
Affiliations
Case Reports

Evans Syndrome

Ahmed Al Hazmi et al. Clin Pract Cases Emerg Med. .

Abstract

A 22-year-old man presented to the emergency department with facial swelling, rash, and fatigue. He had a past medical history of pericarditis and pericardial effusion. His evaluation showed anemia and thrombocytopenia. He was admitted for intravenous administration of steroids, plasmapheresis, and workup of his anemia and thrombocytopenia. He was ultimately diagnosed with Evans syndrome as a presenting feature of systemic lupus erythematosus. Plasmapheresis was stopped but administration of steroids continued. His blood counts improved, and the facial swelling and rash subsided. Evans syndrome is an immunologic conundrum that requires early recognition and treatment.

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Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Figures

Image 1
Image 1
Bilateral facial edema along with edema of the upper lip (arrow).
Image 2
Image 2
Petechial rash (arrow) on upper chest and shoulders.
Image 3
Image 3
Malar rash (arrow) in addition to facial and lip swelling.
See this image and copyright information in PMC

References

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    1. Wang W, Herrod H, Pui CH, et al. Immunoregulatory abnormalities in Evans syndrome. Am J Hematol. 1983;15(4):381–90. - PubMed
    1. Evans RS, Duane RT. Acquired hemolytic anemia; the relation of erythrocyte antibody production to activity of the disease; the significance of thrombocytopenia and leukopenia. Blood. 1949;4(11):1196–213. - PubMed
    1. Shlamovitz GZ, Johar S. A case of Evans’ syndrome following influenza vaccine. J Emerg Med. 2013;44(2):e149–51. - PubMed
    1. Savaşan S, Warrier I, Ravindranath Y. The spectrum of Evans’ syndrome. Arch Dis Child. 1997;77(3):245–8. - PMC - PubMed

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