Interestingly, mutations in genes implicated in primary immunodeficiencies (TNFRSF6, CTLA4, STAT3, PIK3CD, CBL, ADAR1, LRBA, RAG1, and KRAS) have been detected in about half of pediatric patients with AIHA and ITP (Evans Syndrome, ES); mutated patients showed more severe disease with higher treatment requirement and fatal outcome (12). This evidence concerns the gene CTLA4 and autoimmune hemolytic anemia.