Myelophthistic anemia

Background

  • Form of normocytic anemia
  • Associated with infiltrative disorder or bone marrow in the setting of malignancy--leukemia, lymphoma, granuloma

Clinical Features

Differential Diagnosis

Evaluation

  • Requires bone marrow biopsy
  • Labs show normocytic anemia with decreased reticulocyte count
  • Exam with signs of extra medullary hematopoiesis
  • Index of suspicion in setting of malignancy

Management

  • Identify anemia as emergent or non-emergent
  • Evaluate for superimposed etiologies of anemia (Ie acute blood loss) and target treatment in the ED
  • If emergent anemia get IV access, transfuse for signs of end organ damage--altered mental status, hypotension, chest pain, shortness of breath, decreased UOP
  • Will need treatment of underlying malignancy to allow marrow recovery while supporting hemodynamics

Disposition

  • Admit for bone marrow biopsy and treatment of underlying disease

See Also

References

  • Rosen, Peter, John A. Marx, Robert S. Hockberger, and Ron M. Walls. "Anemia". Rosen's Emergency Medicine Concepts and Clinical Practice. 8th ed. Vol. 2. Philadelphia, PA: Elsevier/Saunders, 2013.