The International Journal of Romanian Society of Endocrinology / Registered in 1938

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October - December 2020, Volume 16, Issue 4
Case Report

Calapkulu M, Sencar ME, Yildiz A, Unsal IO, Cakal E

A Rare Clinical Manifestation of Graves’ Disease: Evans Syndrome and a Review of the Literature

Acta Endo (Buc) 2020, 16 (4): 518-521
doi: 10.4183/aeb.2020.518

Evans syndrome is a rare combination of autoimmune hemolytic anemia and immune thrombocytopenia. Evans syndrome in cases of Graves’ disease is extremely rare. The coexistence of these autoimmune diseases suggests that they may share a common pathogenic pathway. The case here presented is of a 36-year old female patient who was admitted for anemia and thrombocytopenia and was diagnosed with Evans syndrome associated with Graves’ disease, and was then treated with methimazole and methylprednisolone (MPSL). During follow-up, MPSL was discontinued gradually over the course of two months. Interestingly, while Evans syndrome is characterized by frequent relapses, this patient has been in remission of Evans syndrome for approximately 1 year without MPSL therapy. The remission of Evans syndrome associated with Graves’ disease in the absence of immunosuppressive therapy suggests that these 2 diseases have a common pathogenetic mechanism.

Keywords: Graves’ Disease, Evans Syndrome, Hyperthyroidism, Anemia, Thrombocytopenia.

Correspondence: Murat Calapkulu MD, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Endocrinology and Metabolism, Sehit Omer Halisdemir Avenue, 06110, Ankara, Turkey, E-mail: