[Pancytopenia, haemolytic anaemia, schistocytes: a frequent pathology mimicking a rare and serious pathology].
A 83 years old woman presents to our hospital with fatigue and dyspnea since 2 weeks, followed by a painless icterus. On laboratory we discover a pancytopenia with severe haemolytic anaemia, thrombopenia and schistocytosis. This association suggest a thrombotic microangiopathy. In the presence of macrocytes, hypersegmented neutrophils and a low reticulocytes count, a vitamin screening was performed witch leads to the discovery of a vitamin B12 and folic acid deficiency. After initiation of a vitamin therapy we observe a reticulocytic crisis and thereafter the normalisation of the haematological parameters.
Monti
M
M
Services de médecine, Département de médecine, CHUV, Lausanne.
Canellini
G
G
Trueb
L
L
Cairoli
A
A
Lamy
O
O
D000368:Aged; D000369:Aged, 80 and over; D000743:Anemia, Hemolytic / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D004906:Erythrocyte Count; D004913:Erythrocytes, Abnormal / Q000473:pathology; D005494:Folic Acid Deficiency / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D010198:Pancytopenia / Q000209:etiology* / Q000473:pathology; D012156:Reticulocytes / Q000473:pathology; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000175:diagnosis* / Q000473:pathology