Myelophthistic anemia: Difference between revisions
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==Background== | ==Background== | ||
*Form of normocytic anemia | *Form of normocytic anemia | ||
*Associated with infiltrative disorder | *Associated with infiltrative disorder of bone marrow in the setting of malignancy--invasive tumor, leukemia, lymphoma, granuloma | ||
==Clinical Features== | ==Clinical Features== | ||
* | *Most pts begin to be symptomatic at ~7gm/dL | ||
* | *Weakness, fatigue, lethargy, DOE, palpitations | ||
*Skin, nail bed, mucosal pallor | |||
*Widened pulse pressure | |||
*Tachycardia/hypotension in severe cases | *Tachycardia/hypotension in severe cases | ||
*Hepatosplenomegaly as sign of extra medullary hematopoiesis | *Hepatosplenomegaly as sign of extra medullary hematopoiesis | ||
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*Anemia of chronic disease | *Anemia of chronic disease | ||
*Hemolytic anemia | *Hemolytic anemia | ||
==Diagnosis== | ==Diagnosis== | ||
*Requires bone marrow biopsy | *Requires bone marrow biopsy | ||
*Labs show normocytic anemia with decreased reticulocyte count | *Labs show normocytic anemia with decreased reticulocyte count | ||
*Exam with signs of extra medullary hematopoiesis | *Exam with signs of extra medullary hematopoiesis | ||
*Index of suspicion in setting of malignancy | *Index of suspicion in setting of malignancy + anemia | ||
==Management== | ==Management== | ||
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==Disposition== | ==Disposition== | ||
*Admit for bone marrow biopsy and treatment of underlying disease | *Admit for bone marrow biopsy and treatment of underlying disease | ||
==See Also== | ==See Also== | ||
*[[Anemia]] | *[[Anemia]] | ||
Revision as of 18:00, 3 August 2015
Background
- Form of normocytic anemia
- Associated with infiltrative disorder of bone marrow in the setting of malignancy--invasive tumor, leukemia, lymphoma, granuloma
Clinical Features
- Most pts begin to be symptomatic at ~7gm/dL
- Weakness, fatigue, lethargy, DOE, palpitations
- Skin, nail bed, mucosal pallor
- Widened pulse pressure
- 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 + anemia
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