Toorians A W, Strack van Schijndel R J
Academisch Ziekenhuis Vrije Universiteit, afd. Inwendige Geneeskunde, Postbus 7057, 1007 MB Amsterdam.
Ned Tijdschr Geneeskd. 2001 Feb 17;145(7):300-6.
A man aged 73, admitted because of unstable angina pectoris also had a anaemia with a haemoglobin concentration of 2.8 mmol/l. The department of Consultative Internal Medicine was asked to elucidate this anaemia. The anamnesis proved to contain extensive diagnostic tests concerning the anaemia which had had no results. In spite of a negative anamnesis, the low serum iron level had prompted an unsuccessful search for a source of haemorrhage in the proximal and distal parts of the digestive tract. The bone marrow had been examined three times without a clear diagnosis. It was also found that there had been a deviation from the classification of anaemia which should be guided by the size of the erythrocyte and the reticulocyte count. This had resulted in diagnostics that where inconvenient to the patient; also the patient had been treated without success with ferrofumarate. Ultimately, he proved to suffer from autoimmune hypothyroidism; the anaemia was resolved by substitution therapy.
一名73岁男性因不稳定型心绞痛入院，同时患有贫血，血红蛋白浓度为2.8 mmol/l。内科咨询部门被要求查明这种贫血的原因。病史显示针对该贫血进行了广泛的诊断测试，但均无结果。尽管病史阴性，但低血清铁水平促使对消化道近端和远端进行了出血源排查，结果未成功。骨髓检查了三次，仍未明确诊断。还发现贫血的分类偏离了应根据红细胞大小和网织红细胞计数来指导的标准。这导致了对患者不便的诊断；此外，患者服用富马酸亚铁治疗也未成功。最终，他被证明患有自身免疫性甲状腺功能减退症；通过替代疗法，贫血得到缓解。
