Background: Antiphospholipid syndrome (APS) is an autoimmune, pro-thrombotic disorder in the presence of circulating antiphospholipid antibodies. EvanÊs syndrome is defined as the presence of autoimmune hemolytic anemia and autoimmune thrombocytopenia is strongly associated with APS and presents a difficult management challenge. Although experience remains limited and uncontrolled mainly due to the prohibitive costs of the drug, the use of intravenous immunoglobulin (IVIg) ???? in combination with high dose steroids - may be beneficial - with reported decline in anticardiolipin antibodies - in the treatment of APSrelated manifestations including EvanÊs syndrome, especially when anti-coagulation is contra-indicated. Setting: St. Luke's Medical Center - a tertiary care hospital