TY - CHAP M1 - Book, Section TI - VASCULAR PURPURA A1 - Hillman, Robert S. A1 - Ault, Kenneth A. A1 - Leporrier, Michel A1 - Rinder, Henry M. PY - 2016 T2 - Hematology in Clinical Practice, 5e AB - CASE HISTORY • Part 1A 46-year-old woman presents with a complaint of more than 3 months of fatigue and dyspnea on exertion. Her history is notable for lifelong recurring epistaxis, requiring repeated nasal packing, septal dermoplasty, and laser therapy. Her father also had repeated epistaxis; he died at age 60 from a brain abscess. Examination is notable for pallor and multiple blue-red lesions involving the lips and fingers. The remainder of the examination is benign except for a positive test for occult blood in the stool.CBC: Hemoglobin/hematocrit - 7 g/dL/22%MCV - 64 fL MCH - 24 pg MCHC - 24 g/dLRDW-CV - 24% WBC count - 6,500/μLPlatelet count - 410,000/μLSMEAR MORPHOLOGYMicrocytic, hypochromic with marked aniso- and poikilocytosis, polychromasia, and the occasional cigar-shaped cell. White blood cells and platelets are both normal.Reticulocyte count/index - 1.3%/<1.0QuestionsHow should the anemia be described and does the history suggest a specific etiology?What additional tests should be ordered to confirm the cause of the anemia? SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/10/09 UR - accessbiomedicalscience.mhmedical.com/content.aspx?aid=1127768159 ER -