Evans Syndrome and Hashimoto's Thyroiditis in Pregnancy: A Case Report

Abstract

Evans syndrome is a combination of autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura. Evans syndrome is a rare disease encountered in medical practice. Evans syndrome can also co-occur with other autoimmune diseases, such as Hashimoto's thyroiditis, although rare. Hashimoto's thyroiditis is a condition that causes hypothyroidism, where the thyroid gland cells are destroyed so that the thyroid hormone produced cannot meet the body's needs. This case report describes a pregnant female patient who has several autoimmune conditions, namely Evans Syndrome and Hashimoto's Thyroiditis. The patient came to the hospital with bruises on the abdomen and waist and felt weak, tired, and lethargic. The previous examination showed that this patient had positive anti-platelet and anti-TPO test results, enlarged liver and spleen on ultrasound examination, and thyroid hormone examination, which showed hypothyroidism. A physical examination of the patient also showed minimal enlargement of the thyroid gland and bruising on the patient's body. The results of routine blood tests showed a decrease in hemoglobin, hematocrit, erythrocyte, and platelet counts. Morphological examination of the peripheral blood revealed the appearance of macroovalocytes and burr cells. During treatment in the ward, the patient was given therapies such as methylprednisolone, levothyroxine, and blood transfusions. During 9 days of treatment in the ward, the patient's clinical condition improved, and there was an increase in hemoglobin, hematocrit, erythrocyte, and platelet counts. The patient was discharged in good condition.