Skill Checkup: A 72-Year-Old Woman With Myelodysplastic Syndrome Presents With Persistent Anemia and Fatigue

Emmanuel C. Besa, MD

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April 08, 2022

In MDS, anemia is usually dimorphic, with a normal or a hypochromic microcytic population (RARS) coexisting with the macrocytes. It is also generally macrocytic (mean cell volume > 100 fL) with RBCs that are oval-shaped (macro-ovalocytes). Punctate basophilia is observed in RBCs. Symptomatic anemia in MDS frequently presents as a hypoproductive macrocytic anemia, often associated with suboptimal elevation of serum erythropoietin (EPO) levels.

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