TPO and Hyperbilirubinemia: Hashimoto thyroiditis is diagnosed by the presence of anti-thyroid peroxidase (TPO) antibodies with decreased uptake in thyroid technetium scan.5 Positive direct coombs test positive in the background of features of hemolysis like hyperbilirubinemia, and increased reticulocytes help make a diagnosis of autoimmune hemolytic anaemia.12 Our case is a typical case of Hashimoto thyroiditis which was diagnosed 2 years back by the presence of anti-thyroid peroxidase (TPO) antibodies with decreased uptake in thyroid technetium scan.