Myelophthistic anemia: Difference between revisions
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*Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Anemia". Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013. | *Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Anemia". Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013. | ||
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Revision as of 13:31, 18 August 2015
Background
- Form of normocytic anemia
- Associated with infiltrative disorder or bone marrow in the setting of malignancy--leukemia, lymphoma, granuloma
Clinical Features
- Anemia in patient with h/o malignancy
- Pale skin
- Tachycardia/hypotension in severe cases
- Hepatosplenomegaly as sign of extra medullary hematopoiesis
Differential Diagnosis
- Aplastic anemia
- Myelofibrosis
- Acute blood loss anemia
- Bone marrow suppression
- Anemia of chronic disease
- Hemolytic anemia
Diagnosis
- Requires bone marrow biopsy
- Labs show normocytic anemia with decreased reticulocyte count
- Exam with signs of extra medullary hematopoiesis
- Index of suspicion in setting of malignancy
Management
- Identify anemia as emergent or non-emergent
- Evaluate for superimposed etiologies of anemia (Ie acute blood loss) and target treatment in the ED
- If emergent anemia get IV access, transfuse for signs of end organ damage--AMS, hypotension, chest pain, shortness of breath, decreased UOP
- Will need treatment of underlying malignancy to allow marrow recovery while supporting hemodynamics
Disposition
- Admit for bone marrow biopsy and treatment of underlying disease
See Also
Sources
- Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Anemia". Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013.