A case of Evans' syndrome following influenza vaccine

J Emerg Med. 2013 Feb;44(2):e149-51. doi: 10.1016/j.jemermed.2012.01.060. Epub 2012 Jul 15.


Background: Evans' syndrome is an uncommon condition defined by the combination (either simultaneously or sequentially) of immune thrombocytopenia purpura and autoimmune hemolytic anemia with a positive direct antiglobulin test in the absence of known underlying etiology.

Objectives: We present a case of Evans' syndrome following influenza vaccination.

Case report: A 50-year-old man with no prior medical history developed Evans' syndrome 4 days after receiving influenza immunization. The patient improved following treatment with oral prednisone and intravenous immunoglobulin.

Conclusion: Influenza vaccine is one of the most commonly used vaccines worldwide, with millions of people being vaccinated annually. Despite its wide use, only sparse information has been published concerning any hematological effects of this vaccine. The rarity of such effects supports the safety of using this vaccine.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Hemolytic, Autoimmune / drug therapy
  • Anemia, Hemolytic, Autoimmune / etiology*
  • Emergency Service, Hospital
  • Gingival Hemorrhage / drug therapy
  • Gingival Hemorrhage / etiology
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Influenza Vaccines / adverse effects*
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Prednisone / therapeutic use
  • Thrombocytopenia / drug therapy
  • Thrombocytopenia / etiology*


  • Glucocorticoids
  • Immunoglobulins, Intravenous
  • Influenza Vaccines
  • Prednisone
  • Methylprednisolone

Supplementary concepts

  • Evans Syndrome