{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T07:56:43Z","timestamp":1774511803674,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Evans syndrome (ES), the coexistence of autoimmune hemolytic anemia and immune thrombocytopenia, can unmask systemic autoimmune disease. We report a 30\u2010year\u2010old woman who presented with fatigue, jaundice, pallor, and mucocutaneous bleeding. Laboratory evaluation demonstrated severe Coombs\u2010positive hemolytic anemia (hemoglobin 5.8\u2009g\/dL, reticulocytosis, high LDH, undetectable haptoglobin) and marked thrombocytopenia, whereas immunologic testing revealed high\u2010titer ANA, anti\u2010dsDNA positivity, and low complement levels; infections, thrombotic microangiopathy, and malignancy were excluded. She was stabilized with transfusion and treated with high\u2010dose corticosteroids and intravenous immunoglobulin, achieving a partial response. Persistent cytopenias prompted rituximab, after which blood counts normalized and hemolysis resolved without major infectious or thrombotic events. At 6 months, she remained in remission on maintenance therapy. This case emphasizes that ES can be the initial manifestation of systemic lupus erythematosus and supports early autoimmune evaluation and tailored immunosuppression to address both cytopenias and underlying disease.<\/jats:p>","DOI":"10.1002\/ccr3.72217","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:53:02Z","timestamp":1773013982000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Hemolysis to Lupus: A Case of Evans Syndrome Revealing Systemic Autoimmunity"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4647-111X","authenticated-orcid":false,"given":"Biruk T.","family":"Mengistie","sequence":"first","affiliation":[{"name":"School of Medicine College of Health Sciences, Addis Ababa University  Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0061-6458","authenticated-orcid":false,"given":"Chernet T.","family":"Mengistie","sequence":"additional","affiliation":[{"name":"School of Medicine College of Health Sciences, Addis Ababa University  Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0556-4071","authenticated-orcid":false,"given":"Mikiyas G.","family":"Teferi","sequence":"additional","affiliation":[{"name":"School of Medicine College of Health Sciences, Addis Ababa University  Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel C.","family":"Teka","sequence":"additional","affiliation":[{"name":"School of Medicine College of Health Sciences, Addis Ababa University  Addis Ababa Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alefe Kedame","family":"Godifey","sequence":"additional","affiliation":[{"name":"School of Medicine College of Health Sciences, Mekelle University  Mekelle Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abel G.","family":"Wubie","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences Bahir Dar University  Bahir Dar Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruke Z.","family":"Abenet","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Atrium Health, Navicent  Macon Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S176144"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2025.101322"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(24)00144-3"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25574"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-024-05002-3"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2011.07.004"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-04-215368"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2019.100648"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9123851"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003279"},{"issue":"3","key":"e_1_2_14_12_1","article-title":"A Practical Perspective of the Hematologic Manifestations of Systemic Lupus Erythematosus","volume":"14","author":"Santacruz J. 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