Abstract

Evans syndrome is an auto immune disorder in which antibodies attack RBC, platelets and or neutrophil. The disorder resembles a combination of AIHA + ITP and or Neutropenia. A 21 years old girl presented to OPD with sudden acute painless loss of vision in both eyes since 2 weeks. She had past history of menorrhagia ,gum bleeding, petechiae, weakness & fever and diagnosed as Evans syndrome 10 years back. She received treatment for the same and following which there was a period of symptomatic remission. Visual acuity in R/E & L/E was 6/60 & HM+ respectively. IDO examination showed disc edema, tortuous vessels, retinal hemorrhages and macular star. Patient presented with anemia, thrombocytopenia, raised indirect bilirubin, comb's test positive, LDH & reticulocytes count was raised. Based on these, patient was diagnosed as Evans syndrome. Patient was treated conservatively and improved on follow up.