title: Cryptogenic hepatic insult, failing heart and advancing age: a case report.
abstract: BACKGROUND
  Weakness and fatigue are accepted as normal accompaniments of aging. Usually, older individuals are not investigated with much enthusiasm but a treatable cause is discernible on several occasions.
  
  
  METHODS
  We had a 67 year old hypertensive lady with a mitral stenosis, presenting in ischemic or hypertensive heart failure with underlying valvular disease, without pulmonary hypertension in sinus rhythm. She had pancytopenia with severe anemia and raised liver enzymes. Bone marrow examination showed aplastic anemia. She was treated with ATG and improved subsequently to become transfusion free. However, she succumbed to an unrelated sudden cardiac death.
  
  
  CONCLUSIONS
  Our patient is unique in her uncommon presentation, complex management issues and a favorable outcome after a long and persevering therapeutic intervention and finally her sudden death.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, ND 110029, India. ashgoe@yahoo.com.
authors.forename: Akansha
authors.initials: A
authors.lastname: Agrawal
authors.forename: Manish
authors.initials: M
authors.lastname: Soneja
authors.forename: Ashish
authors.initials: A
authors.lastname: Goel
authors.forename: H
authors.initials: H
authors.lastname: Pati
authors.forename: Aparajit B
authors.initials: AB
authors.lastname: Dey