Myelophthistic anemia: Difference between revisions
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==Background== | ==Background== | ||
*Form of normocytic anemia | *Form of normocytic [[anemia]] | ||
*Associated with infiltrative disorder or bone marrow in the setting of malignancy--leukemia, lymphoma, granuloma | *Associated with infiltrative disorder or bone marrow in the setting of malignancy--[[leukemia]], [[lymphoma]], granuloma | ||
==Clinical Features== | ==Clinical Features== | ||
*Anemia in patient with history of malignancy | *[[Anemia]] in patient with history of malignancy | ||
*Pale skin | *Pale skin | ||
*Tachycardia/hypotension in severe cases | *[[Tachycardia]]/[[hypotension]] in severe cases | ||
*Hepatosplenomegaly as sign of extra medullary hematopoiesis | *[[hepatomegaly|Hepatosplenomegaly]] as sign of extra medullary hematopoiesis | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Aplastic anemia | *[[Aplastic anemia]] | ||
*Myelofibrosis | *[[Myelofibrosis]] | ||
*Acute blood loss anemia | *[[hemorrhage|Acute blood]] loss anemia | ||
*Bone marrow suppression | *Bone marrow suppression | ||
*Anemia of chronic disease | *Anemia of chronic disease | ||
*Hemolytic anemia | *[[Hemolytic anemia]] | ||
==Evaluation== | ==Evaluation== | ||
*Requires bone marrow biopsy | *Requires bone marrow biopsy | ||
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*Identify anemia as emergent or non-emergent | *Identify anemia as emergent or non-emergent | ||
*Evaluate for superimposed etiologies of anemia (Ie acute blood loss) and target treatment in the ED | *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--altered mental status, hypotension, chest pain, shortness of breath, decreased UOP | *If emergent anemia get IV access, [[pRBCs|transfuse]] for signs of end organ damage--altered mental status, hypotension, chest pain, shortness of breath, decreased UOP | ||
*Will need treatment of underlying malignancy to allow marrow recovery while supporting hemodynamics | *Will need treatment of underlying malignancy to allow marrow recovery while supporting hemodynamics | ||
Latest revision as of 05:00, 1 October 2019
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 history of 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
Evaluation
- 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--altered mental status, 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
References
- 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.