A Curious Case of Iron-Deficiency Anemia.
Seth R ShafferMayur BrahmaniaHemant A ShahPublished in: Canadian journal of gastroenterology & hepatology (2016)
A 49-year-old Brazilian male presented to the emergency department with a five-day history of abdominal pain, dark stools, and syncope. Physical examination did not reveal any melena on digital rectal examination and there were no stigmata of chronic liver disease. Laboratory results showed hemoglobin of 47 g/L, MCV of 80 fL, and ferritin of 6 ng/mL. Liver enzymes and liver function tests were normal. Abdominal ultrasound showed a cirrhotic liver with splenomegaly and varices suggestive of portal hypertension. His past history was significant for cirrhosis based on a previous variceal bleed but a workup for chronic liver disease was negative and a liver biopsy did not show steatosis, fibrosis, or cirrhosis. A gastroscopy in this admission showed large esophageal varices without high-risk stigmata and no overt bleeding was seen. A colonoscopy was subsequently completed to the terminal ileum and was normal aside from a 5 mm sessile polyp in the descending colon.
Keyphrases
- iron deficiency
- emergency department
- abdominal pain
- blood pressure
- magnetic resonance imaging
- physical activity
- insulin resistance
- mental health
- ultrasound guided
- pulmonary embolism
- dna methylation
- chronic kidney disease
- high fat diet
- genome wide
- gene expression
- single cell
- metabolic syndrome
- computed tomography
- adipose tissue
- drug induced
- high fat diet induced
- adverse drug