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Case Reports in Pediatrics
Volume 2017, Article ID 5184587, 3 pages
https://doi.org/10.1155/2017/5184587
Case Report

Evans Syndrome Complicated by Intratubular Hemoglobin Cast Nephropathy

The Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children’s Hospital, Washington University Medical Center, St. Louis, MO, USA

Correspondence should be addressed to Iván González; ude.ltsuw@izelaznog

Received 27 July 2017; Accepted 14 September 2017; Published 15 October 2017

Academic Editor: Giovanni Montini

Copyright © 2017 Iván González et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Evans syndrome (ES) is a rare autoimmune disorder whose exact pathophysiology is unknown. It is characterized by the simultaneous or subsequent development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Intravascular hemolysis, with hemoglobinemia, is known to produce acute kidney injury; however, the development of intratubular hemoglobin casts (hemoglobin cast nephropathy) in the setting of acute hemolysis is uncommon. Likewise, the association of ES and acute renal failure is equally uncommon. We present a case of a 7-year-old girl with ES who developed acute kidney injury in the setting of intravascular hemolysis and had widespread intratubular hemoglobin casts.