SHM Converge Scientific Abstract ePoster Gallery-Evans Syndrome One Month After Covid-19 Infection: A Rare Condition

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This case report describes an 84-year-old woman who developed Evans syndrome about one month after recovering from COVID-19. Evans syndrome is a rare autoimmune disorder combining autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP), leading to severe anemia and dangerously low platelet counts.<br /><br />The patient had a history of hypertension, diabetes, congestive heart failure, and hypothyroidism. After a recent COVID-19 infection, she developed progressive weakness over two weeks and then fell when trying to stand from a chair. At the outside emergency department, she was found to be tachycardic and hypotensive, with hemoglobin of 6.8 g/dL and platelets of 2,000/uL. She also had elevated bilirubin and creatinine and received blood and platelet transfusions before transfer.<br /><br />At the receiving hospital, she had extensive bruising and ecchymoses. Laboratory studies showed persistent anemia and thrombocytopenia, along with evidence of hemolysis, including elevated LDH, low haptoglobin, low fibrinogen, and decreased antithrombin III. Hematology suspected an immune-mediated process and started high-dose methylprednisolone. Bone marrow biopsy and blood smear ruled out myelodysplastic syndrome, supporting the diagnosis of Evans syndrome.<br /><br />Although her blood counts slowly improved, her condition worsened on hospital day 8 when her mental and respiratory status declined. Imaging showed a new left lower-lobe opacity, and she became unresponsive and was transferred to the ICU. She died later that day.<br /><br />The authors note that COVID-19 may trigger immune dysregulation and autoimmune cytopenias like Evans syndrome. This case highlights the possibility of severe, life-threatening post-COVID autoimmune complications, especially in older adults.

Asset Subtitle

Donald A. Fearn

Meta Tag

Author List Donald A. Fearn, John Whitecar, Joseph Noonan, Matthew Wade

Category Clinical Vignettes

Concept Evans Syndrome

Concept Autoimmune Hemolytic Anemia

Concept Immune Thrombocytopenia

Distinguished Non-Finalist

Presenter Organization Baptist Memorial Hospital- Golden Triangle

Presenting Author Donald A. Fearn

Track Adult

Keywords

Evans syndrome

COVID-19

autoimmune hemolytic anemia

immune thrombocytopenic purpura

thrombocytopenia

hemolysis

elderly patient

post-COVID complication

methylprednisolone

case report

Evans Syndrome

Autoimmune Hemolytic Anemia

Immune Thrombocytopenia