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Acute on chronic anaemia with a haemoglobin of 18 g/L (1.8 g/dL) and haematocrit of 7.2%
  1. Shelly Fay Haferkamp1,
  2. Sundar Venkata Cherukuri1,
  3. Sri Laxmi Valasareddi2 and
  4. Amith Skandhan3
  1. 1 Medical Education, Alabama College of Osteopathic Medicine, Dothan, Alabama, USA
  2. 2 Hematology and Oncology, Southeast Health, Dothan, Alabama, USA
  3. 3 Internal Medicine Residency Program, Southeast Health, Dothan, Alabama, USA
  1. Correspondence to Shelly Fay Haferkamp, haferkampsf{at}


Anaemia can present with symptoms of fatigue, shortness of breath, weakness, malaise, tachycardia and skin pallor. If left untreated, this can progress to life-threatening complications such as arrhythmias, cardiac hypertrophy and myocardial infarction. In this report, a 43-year-old woman, who was ambulatory with no exertional dysponea, presented with weakness, fatigue, bilateral lower extremity oedema and intermittent right sided chest pain for several months. This patient was subsequently found to have a haemoglobin of 18 g/L (1.8 g/dL) and haematocrit of 7.2%. She was admitted to the hospital and treated with seven units of blood. CT scan showed a 9.6 cm uterine fibroid in addition to a 5.9×5.4 cm mass near the right kidney, which was later diagnosed as metastatic carcinoid tumour. This case deserves attention due to the importance of looking for multiple causes of blood loss and the effects of low haemoglobin levels.

  • cancer - see oncology
  • oncology
  • stroke
  • haematology (incl blood transfusion)

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  • Patient consent for publication Obtained.

  • SFH and SVC contributed equally.

  • Contributors SFH and SVC both contributed by writing and editing the case report. SLV provided oncological care for the patient and guided the medical students questions in addition to editing the case report. AS in addition to caring for the patient, guided the aforementioned medical students and edited the report multiple times.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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