Second-line treatment for refractory Evans syndrome includes rituximab, mofetil mycophenolate, cyclosporine, vincristine, azathioprine, sirolimus and thrombopoietin receptor agonists.1 The woman in our case was also managed with blood transfusion, and platelet transfusion and did well with rituximab and corticosteroids and our treatment was parallel with the treatment modalities highlighted in other literature. The gene discussed is MPL; the disease is Evans syndrome.