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2009:
Reibke R; Hausmann A; Cnossen J; Hiddemann W; Spiekermann K; Braess J
[Severe microcytic anemia with megaloblastic changes in the bone marrow. A hematological paradoxon?]
Der Internist 2009;
50(
7):.
We discuss the case of a 32 year-old male with severe microcytic anemia (hemoglobin 2,9 g/dl) and megaloblastic changes in the bone marrow. The patient reported of substantial dietary weight loss. The family history was positive for beta-thalassemia. Previous blood work showed iron deficiency with mild anemia. Further work-up verified beta-thalassemia minor and revealed severely decreased vitamin B12 levels with positive anti intrinsic-factor antibodies, pathognomonic for autoimmune pernicious anemia. The paradoxon therefore dissolved as a pernicious anemia with megaloblastic changes with microcytic erythrocytes due to beta-thalassemia.
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