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87-Year-Old Man With Macrocytic Anemia

Source: www.mayoclinicproceedings.com
Topic: Megaloblastic anemia
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Sort Desciption: Macrocytosis can result from either megaloblastic or. nonmegaloblastic anemia. Megaloblastic anemia usually. produces oval macrocytes and results from defective DNA ...

Content Inside:
An 87-year-old man was referred to our institution because of a 4-month history of progressive fatigue and orthostatic symptoms. Mild anemia (hemoglobin concentration, 11.1 g/dL) was noted 4 months before the onset of symptoms, but his hemoglobin concentration (14.0 g/ dL) was normal 15 months before that. He had no episodes of syncope but noticed poor exercise tolerance, making it difficult to continue bowling, his favorite pastime. No change was noted in appetite or weight, and he experienced no fever, chills, cough, chest pain, shortness of breath, palpitations, abdominal pain, or altered bowel pattern. The patient had no history of recurrent infections and was not aware of excessive bruising or any source of blood loss, particularly from the gastrointestinal or genitourinary tract. There was no history of recent blood transfusions, but he had taken iron supplements for a few weeks 1 year before presentation and continued to take a daily oral multivitamin with iron since that time. He denied taking any other medications. His medical history included sensorineural hearing loss, Gilbert disease, mild dependent edema, and diverticulosis coli. Physical examination revealed ...

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