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Evans syndrome is a rare autoimmune disorder in which the immune system mistakenly attacks red blood cells and platelets, causing autoimmune haemolytic anaemia and immune thrombocytopenia, either simultaneously or at different times. In some patients, immune neutropenia may also occur. The condition can develop independently or alongside other autoimmune diseases, immune deficiencies, infections, or lymphoproliferative disorders.

Symptoms depend on the affected blood cells. Anaemia may cause fatigue, weakness, pale skin, shortness of breath, dizziness, or rapid heartbeat. Low platelet levels can lead to easy bruising, petechiae, nosebleeds, or excessive bleeding. Diagnosis involves blood counts, blood film examination, reticulocyte testing, bilirubin and lactate dehydrogenase measurements, and a direct antiglobulin test. Other causes of haemolysis and thrombocytopenia must be excluded.

Treatment aims to control abnormal immune activity and prevent complications. Corticosteroids are commonly used as initial therapy, while intravenous immunoglobulin may be considered when a rapid increase in platelet levels is needed. Relapsing or treatment-resistant cases may require rituximab, immunosuppressive medicines, or other specialist therapies. Regular monitoring of blood counts is important because Evans syndrome often follows a chronic, relapsing course. Early diagnosis and individualized treatment can help reduce bleeding, anaemia, and other complications.