{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:09:09Z","timestamp":1772168949586,"version":"3.50.1"},"reference-count":7,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T00:00:00Z","timestamp":1550102400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background:<\/ns4:bold>\n                    Celiac disease is an immune-mediated enteropathy due to permanent sensitivity to gluten in genetically predisposed individuals. Evans syndrome is an autoimmune disorder designated with simultaneous or successive development of autoimmune hemolytic anemia and immune thrombocytopenia and\/or immune neutropenia in the absence of any cause.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Case Report:<\/ns4:bold>\n                    We report a rare case of Celiac disease and Evans syndrome in a 20-year-old female who presented to us with generalized weakness and shortness of breath. Her examination finding included anemia, jaundice, and raised jugular venous pulse. Her abdominal exam revealed hepatosplenomegaly. Her laboratory values showed microcytic anemia, leukocytosis and thrombocytopenia. To rule out secondary causes of idiopathic thrombocytopenia purpura, we tested viral markers for Human immunodeficiency virus, Epstein bar virus, Cytomegalovirus and performed a\n                    <ns4:italic>Helicobacter pylori<\/ns4:italic>\n                    test, all of which were negative. We also ruled out idiopathic thrombocytopenia purpura associated with any thyroid disorder.\u00a0 For celiac disease, we took anti-tissue transgulataminase titers of IgA and IgG which confirmed the diagnosis of celiac disease. For the diagnosis of Evans syndrome, despite a negative serum coombs test initially, her bone marrow sample showed a positive Coombs test along with immune mediated hemolytic anemia and immune mediated thrombocytopenia. The patient was treated with prednisone which was tapered off and counseling was provided regarding a gluten free diet.\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusion:<\/ns4:bold>\n                    Although rare, tests for Evans syndrome (and other coexisting autoimmune problems) should be performed in patients with celiac disease.\n                  <\/ns4:p>","DOI":"10.12688\/f1000research.18182.1","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T09:16:35Z","timestamp":1550135795000},"page":"181","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: Rare comorbidity of celiac disease and Evans syndrome"],"prefix":"10.12688","volume":"8","author":[{"given":"Syed Mohammad Mazhar","family":"Uddin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aatera","family":"Haq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zara","family":"Haq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5910-2875","authenticated-orcid":false,"given":"Uzair","family":"Yaqoob","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2019,2,14]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"4399-4403","DOI":"10.3748\/wjg.v18.i32.4399","article-title":"Tissue transglutaminase levels above 100 U\/mL and celiac disease: a prospective study.","volume":"18","author":"A Mubarak","year":"2012","journal-title":"World J Gastroenterol."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"633-635","DOI":"10.1097\/MPH.0b013e318142ac48","article-title":"A rare condition associated with celiac disease: Evans syndrome.","volume":"29","author":"N Yarali","year":"2007","journal-title":"J Pediatr Hematol Oncol."},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"3167-3172","DOI":"10.1182\/blood-2009-04-215368","article-title":"The spectrum of Evans syndrome in adults: new insight into the disease based on the analysis of 68 cases.","volume":"114","author":"M Michel","year":"2009","journal-title":"Blood."},{"key":"ref-4","doi-asserted-by":"publisher","first-page":"1731-1743","DOI":"10.1056\/NEJMra071600","article-title":"Celiac disease.","volume":"357","author":"P Green","year":"2007","journal-title":"N Engl J Med."},{"key":"ref-5","doi-asserted-by":"publisher","first-page":"100-106","DOI":"10.1159\/000016911","article-title":"Clinical features of celiac disease today.","volume":"17","author":"P Collin","year":"1999","journal-title":"Dig Dis."},{"key":"ref-6","doi-asserted-by":"publisher","first-page":"96-102","DOI":"10.1038\/cmi.2010.64","article-title":"Celiac disease: diagnostic criteria in progress.","volume":"8","author":"U Volta","year":"2011","journal-title":"Cell Mol Immunol."},{"key":"ref-7","doi-asserted-by":"publisher","first-page":"629-630","DOI":"10.1136\/pgmj.60.707.629","article-title":"Coeliac disease with autoimmune haemolytic anaemia.","volume":"60","author":"D Miller","year":"1984","journal-title":"Postgrad Med J."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/8-181\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-181\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/8-181\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T05:10:09Z","timestamp":1562303409000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/8-181\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,14]]},"references-count":7,"URL":"https:\/\/doi.org\/10.12688\/f1000research.18182.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.19888.r50760","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.19888.r49207","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.19888.r50760","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.19888.r49207","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,14]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/8-181\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.19888.r49207, Lucia Terzuoli, Department of Medical Biotechnologies, University of Siena, Siena, Italy, 17 Jun 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/8-181\/v1#referee-response-49207","order":0,"name":"referee-response-49207","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Uzair Yaqoob<\/b>; \n<i>Posted: 18 Jun 2019<\/i>; Thank you for your valuable comments","URL":"https:\/\/f1000research.com\/articles\/8-181\/v1#referee-comment-4700","order":1,"name":"referee-comment-4700","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.19888.r50760, Kofi Clarke, Department of Medicine, Division of Gastroenterology and Hepatology, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA, 05 Jul 2019, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/8-181\/v1#referee-response-50760","order":2,"name":"referee-response-50760","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}