Refractory/Relapse Thrombocytopenia in a Patient With Evans' Syndrome Successfully Treated With Zanubrutinib

A 15-year-old Chinese girl with severe refractory/relapsed thrombocytopenia due to Evans' syndrome (ES) was successfully treated with zanubrutinib after failing multiple conventional therapies, including corticosteroids, rituximab, and splenectomy. Upon administration of zanubrutinib (160 mg twice daily), her platelet count significantly improved, reaching over 100×10^9/L within 6 months, and she achieved remission despite discontinuing the drug due to hair loss and cost. This case highlights zanubrutinib's potential as an effective treatment for ES, particularly in patients unresponsive to standard therapies, and suggests that it may work by targeting B cells. Further studies are needed to explore its broader application.