Fernandes Gaspar, Ruivo Tiago, Ramos Óscar
Family Medicine, Family Health Unit (USF) Almedina, Local Health Unit of Trás-os-Montes and Alto Douro (ULSTMAD), Lamego, PRT.
Cureus. 2024 Dec 14;16(12):e75689. doi: 10.7759/cureus.75689. eCollection 2024 Dec.
Easy bruising and ecchymosis are common symptoms in clinical practice, yet distinguishing benign from clinically significant cases can be challenging. We report the case of a 46-year-old woman who presented in December 2023 with easy bruising and increased menstrual flow, revealing new-onset pancytopenia in laboratory tests. Initially diagnosed with Acute Myeloid Leukemia inversion (inv) (16), subsequent results were inconclusive, leading to a diagnosis of Paroxysmal Nocturnal Hemoglobinuria (PNH). Following clinical and analytical deterioration, a repeat bone marrow study in March 2024 identified Aplastic Anemia (AA). When evaluating easy bruising and ecchymosis, a thorough history and physical examination are essential, sometimes requiring further investigation and referral. AA is a rare and heterogeneous disease that requires excluding other causes of bone marrow failure for proper diagnosis. Its severity and the patient's age determine treatment and prognosis. This case underscores the importance of investigating common symptoms that may signal serious underlying conditions, as well as the complexities involved in diagnosing AA.
在临床实践中，易出现瘀斑和瘀点是常见症状，但区分良性病例与具有临床意义的病例可能具有挑战性。我们报告了一例46岁女性病例，该患者于2023年12月出现易瘀斑和月经量增多症状，实验室检查显示新发全血细胞减少。最初诊断为急性髓系白血病倒位（inv）（16），后续结果不明确，最终诊断为阵发性睡眠性血红蛋白尿（PNH）。在临床和分析病情恶化后，2024年3月再次进行骨髓检查确诊为再生障碍性贫血（AA）。在评估易瘀斑和瘀点时，全面的病史和体格检查至关重要，有时还需要进一步检查和转诊。AA是一种罕见的异质性疾病，正确诊断需要排除其他骨髓衰竭原因。其严重程度和患者年龄决定治疗方案和预后。该病例强调了对可能预示严重潜在疾病的常见症状进行调查的重要性，以及诊断AA所涉及的复杂性。
