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How to exhaust your bone marrow
  1. Louise Salomo1,
  2. Morten Salomo2,
  3. Steven A W Andersen2,
  4. Anne-Lise Kamper1
  1. 1Department of Nephrology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
  2. 2Department of Haematology, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
  1. Correspondence to Louise Salomo, Louise{at}


A 32-year-old man was admitted to the hospital because of oedema and 8 kg of gained weight. The oedema decreased spontaneously over weeks and there was no evidence for a nephrotic syndrome; however, the blood tests revealed a moderate pancytopenia. The patient practiced excessive physical activity at work and in his spare time, and kept a very thorough training and weight diary. Owing to a high intake of energy and protein drinks he tried to optimise his physical performance and kept a normal body mass index  at 23.7. A bone marrow biopsy showed gelatinous bone marrow transformation, normally seen in critically ill patients or those with severe malnutrition. In this case, the cause is presumed to be excessive physical activity/overtraining in combination with relatively insufficient nutrition.

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