# Multisystem Complications in Postpartum-Onset Evans Syndrome: A Case Report

## TL;DR

A postpartum woman developed rare Evans syndrome with multiple complications, highlighting the challenges in diagnosing and treating this condition.

## Contribution

This case report emphasizes the diagnostic and therapeutic challenges of Evans syndrome triggered by pregnancy.

## Key findings

- The patient presented with multisystem complications including anemia, thrombocytopenia, and acute kidney injury.
- Treatment involved a combination of steroids, IV immunoglobulin, mycophenolate, and eculizumab.
- Evans syndrome triggered by pregnancy or infection poses significant diagnostic and therapeutic challenges.

## Abstract

A 35-year-old postpartum woman presented with gastrointestinal symptoms, anemia, thrombocytopenia, and acute kidney injury (AKI) and later suffered from splenic rupture. After extensive evaluation, she was diagnosed with Evans syndrome (ES). ES is characterized by the co-occurrence of multiple autoimmune cytopenias (AIC), most commonly autoimmune hemolytic anemias (AIHA) and immune thrombocytopenia (ITP). Since the incidence is exceedingly rare, the management is considerably difficult due to a lack of structured guidelines, leading to considerable patient morbidity. Our patient’s treatment regimen included combinations of steroids, IV immunoglobulin, mycophenolate, and eculizumab. Here, we highlight the diagnostic complexity and therapeutic challenges associated with ES, particularly when triggered by pregnancy or infection.