Anemia of Unknown Origin in an 80-Year-Old Woman

Kathy D. Miller, MD; Jill Kremer, MD


July 30, 2015

Physical Examination and Workup

The physical examination is notable for an older but vibrant woman. No signs of distress are noted. Her vital signs include a temperature of 97.7° F (36.5° C), heart rate of 93 beats/min, blood pressure of 132/69 mm Hg, respirations of 14 breaths/min, and a weight of 139.5 lb (139 lb 1 year prior).

Figure 1.

Figure 2.

The patient has an unremarkable physical examination except for minimal pallor and postsurgical and radiation changes, including significant telangiectasia over the right chest wall and capsular contracture around her implant reconstruction on the left. She has normal bowel sounds with no abdominal tenderness. The liver and spleen are not palpable. A musculoskeletal examination does not reveal any areas of localized tenderness.

Further laboratory studies are significant for a sedimentation rate of 88 mm/hr. Bone marrow biopsy and nuclear bone scan are obtained for further workup. Peripheral smears are shown (Figures 1 and 2).


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