Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 5, Issue 4 | Case Report | Open Access

From Cytopenia to Clot: Evans Syndrome Presenting as Acute Portal Vein Thrombosis with Rapid-Onset Ascites

S Anton Charles*

Harsha Vardhan Alagari1, Ananya Sahu2, S.N.V Priya Sri Harshitha3, Debdip Ghosh4, Kanishka Verma5, S Anton Charles6*, Shaun Nevil6 and Chaitra CS7

1Prathima Institute of Medical Sciences, Karimnagar, India

2Grant Government Medical College, India

3Apollo Institute of Medical Sciences and Research, India

4Rajarajeshwari Medical College, Karnataka, India

5Sri Guru Ram Das Institute of Medical Sciences and Research, India

6Department of Internal Medicine, ESIC Medical College & PGIMSR, Karnataka, India

7Assistant Professor, Department of Internal Medicine, ESIC Medical College & PGIMSR, Karnataka, India

*Correspondence to: S Anton Charles 

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Abstract

Evans syndrome is a rare autoimmune condition characterized by the coexistence of autoimmune hemolytic anemia and immune thrombocytopenia, with a paradoxical predisposition to thrombosis. We report a 51-year-old male presenting with rapidly progressive ascites and bilateral pedal edema, subsequently diagnosed with acute portal vein thrombosis leading to non-cirrhotic portal hypertension. Laboratory evaluation demonstrated hemolysis and thrombocytopenia, confirming Evans syndrome after exclusion of secondary causes. Despite thrombocytopenia, prothrombotic mechanisms including endothelial dysfunction, platelet activation, and hemolysis-associated hypercoagulability likely contributed to thrombosis. The patient was managed with supportive therapy and planned anticoagulation following platelet stabilization. This case underscores the importance of recognizing thrombotic complications in autoimmune cytopenias and highlights the need for early diagnosis and individualized management to optimize outcomes.

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Citation:

Harsha Vardhan Alagari, Ananya Sahu, S.N.V Priya Sri Harshitha, Debdip Ghosh, Kanishka Verma, S Anton Charles, et al. From Cytopenia to Clot: Evans Syndrome Presenting as Acute Portal Vein Thrombosis with Rapid-Onset Ascites. Ann Case Rep Clin Stud. 2026;5(4):1-6.