Cerrano Marco, Crisà Elena, Giai Valentina, Boccadoro Mario, Ferrero Dario
Hematology Division, Università degli Studi di Torino, Turin, Italy.
Mediterr J Hematol Infect Dis. 2016 Feb 25;8(1):e2016017. doi: 10.4084/MJHID.2016.017. eCollection 2016.
Anemia in the elderly is a common but challenging clinical scenario. Here we describe the case of an older woman who presented with anemia and elevated inflammation markers. After a complete diagnostic work-up, a definite etiology of the anemia could not be found so eventually a bone marrow biopsy was performed and she was diagnosed with myelodysplastic syndrome. She responded well to erythropoietin treatment but her inflammation markers remained elevated thus a positron emission tomography was performed. It turned out that the patient suffered from giant cell artheritis and her anemia completely resolved after steroid treatment. Our case outlines that it is necessary to pay particular attention to anemia of inflammation, which could be due to several and often masked conditions. Myelodysplatic syndromes should be considered when other causes have been ruled out, but their diagnosis can be difficult and requires expertise in the field.
老年人贫血是一种常见但具有挑战性的临床情况。在此，我们描述一位老年女性的病例，她表现为贫血且炎症标志物升高。经过全面的诊断检查，未能找到贫血的确切病因，最终进行了骨髓活检，她被诊断为骨髓增生异常综合征。她对促红细胞生成素治疗反应良好，但炎症标志物仍居高不下，因此进行了正电子发射断层扫描。结果发现该患者患有巨细胞动脉炎，类固醇治疗后她的贫血完全缓解。我们的病例表明，有必要特别关注炎症性贫血，这可能由多种且常常隐匿的病症引起。当排除其他病因后应考虑骨髓增生异常综合征，但其诊断可能困难，需要该领域的专业知识。
