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A Case of Evans Syndrome with Acute Hemolysis and Hemoglobin Cast Nephropathy

Felicia Sadie Couri, Manasa Kandula

(Department of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA)

Am J Case Rep 2020; 21:e920760

DOI: 10.12659/AJCR.920760


BACKGROUND: Evans syndrome is characterized by ‘warm’ autoimmune hemolytic anemia and autoimmune thrombocytopenia, and is more common in the pediatric population than in adults. Evans syndrome is often associated with underlying autoimmune disease, connective tissue disease, immune deficiency disorders, lymphoproliferative disorders, or malignancy of the immune system. A case is presented of acute kidney injury due to hemoglobin cast nephropathy in an adult man with Evans syndrome.
CASE REPORT: A 60-year-old man was diagnosed with Evans syndrome, which was complicated by acute renal failure that required treatment with hemodialysis. Laboratory tests and renal histology confirmed a diagnosis of hemolysis-associated hemoglobin cast nephropathy.
CONCLUSIONS: The diagnosis of Evans syndrome is important as it may be associated with underlying hematological and immunological disorders. Although rare, hemoglobin cast nephropathy due to hemolysis can be a cause of acute kidney injury in patients with Evans syndrome.

Keywords: acute kidney injury, Anemia, Hemolytic, Anemia, Hemolytic, Autoimmune, Purpura, Thrombocytopenic, Idiopathic, Thrombocytopenia

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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