Editor,—Savaşan et al describe the diverse immune abnormalities, limited effect of different therapeutic manoeuvres (splenectomy, steroids, intravenous immunoglobulins), and poor prognosis in patients with autoimmune thrombocytopenia and Coombs positive haemolytic anaemia (Evans’ syndrome).1 Fifty five per cent of their patients (six out of 11) had hepatomegaly, some with portal triaditis. We would like to extend their findings by reporting our recent experience of a patient with Evans’ syndrome who also had Coombs positive giant cell hepatitis (CPGCH). CPGCH is a rare disease of early childhood, with unknown pathogenesis and variable response to immunosuppression.2Liver transplantation is not curative, since the disease recurs in the graft.3

An Asian girl, born from consanguineous parents, was diagnosed …