Evans syndrome is an uncommon condition characterised by simultaneous or 
sequential development of immune thrombocytopenia (ITP) and autoimmune 
haemolytic anaemia (AIHA) with a positive direct antiglobulin test (DAT) in the 
absence of a known underlying aetiology. The great majority of patients with 
Evans syndrome have a chronic relapsing course despite treatment, which is 
associated with significant morbidity and mortality. We reviewed the clinical 
and laboratory features of six patients with Evans syndrome. All patients had 
thrombocytopenia, bleeding symptoms and haemolytic anaemia with positive direct 
Coombs test at presentation. We discuss the aetiopathogenic, clinical, 
therapeutic and natural history of Evans syndrome.