Myelophthistic anemia

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

Anemia

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.

This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.