TY - JOUR T1 - Foot-strike haemolysis in an ultramarathon runner JF - BMJ Case Reports DO - 10.1136/bcr-2017-220661 VL - 2017 SP - bcr-2017-220661 AU - Abid A Fazal AU - Mary S Whittemore AU - Katharine C DeGeorge Y1 - 2017/12/12 UR - http://casereports.bmj.com/content/2017/bcr-2017-220661.abstract N2 - This case report describes mild anaemia and intravascular haemolysis in an otherwise healthy 41-year-old ultramarathon runner. In long-distance endurance athletes, trace gastrointestinal bleeding and plasma volume expansion are recognised sources of mild anaemia, often found incidentally. However, repetitive forceful foot striking can lead to blood cell lysis in the feet, resulting in a mild macrocytic anaemia and intravascular haemolysis, as was demonstrated in the patient described herein. Mild anaemia in runners, often called ‘runner’s pseudoanaemia’, is typically clinically insignificant and does not require intervention. However, an unexplained anaemia can cause undue worry for otherwise healthy patients and lead to costly further testing, providing an argument against routine testing with complete blood counts in healthy, asymptomatic patients. ER -