Myelophthistic anemia: Difference between revisions
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*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 | *Anemia in patient with history of malignancy | ||
*Pale skin | *Pale skin | ||
*Tachycardia/hypotension in severe cases | *Tachycardia/hypotension in severe cases | ||
Revision as of 01:54, 14 July 2016
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
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
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.