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Cases | A Patient with Anemia
Discussion
The intern orders a Fe study which reveal the following:
Serum Fe 20 ug/dL
Serum TIBC 400 ug/dl
Serum ferritin 10ug/L
The patient is discharged with Fe supplementation, but returns
to the Emergency Department with minimal change in her symptoms. Her repeat
CBC shows:
Hgb 8
Hct 24
WBC 3.8
MCV 112
- What would your differential diagnosis be now, and what additional tests
would you order?
The peripheral smear is reviewed and reveals two six lobed PMNs in addition
to macroovalocytes.
- Describe a plausible scenario to explain the patient's entire presentation.
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