Cases reported "Anemia, Hypochromic"

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1/25. Antral vascular ectasia: the watermelon stomach.

    Antral vascular ectasia (watermelon stomach) is an uncommon localised vascular abnormality which may cause occult gastrointestinal blood loss and iron deficiency anaemia. The endoscopic appearances are characteristic with well demarcated, often raised or nodular bright red streaks radiating from the pylorus back along the antrum. Endoscopic biopsies can be taken without risk of haemorrhage and may help distinguish this condition from gastritis. The aetiology remains obscure, but there is an association with achlorhydria, hypergastrinaemia, and cirrhosis of the liver. Four patients are described; two had antrectomy with long term control of their anaemia, and two were treated conservatively. The lesion may be diagnosed more frequently with more widespread recognition of the condition.
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keywords = blood loss, haemorrhage
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2/25. Iron deficiency and anemia of chronic disease. Clues to differentiating these conditions.

    Iron deficiency occurs when the body's iron stores are exhausted. The source of blood loss leading to iron deficiency must be identified in all cases. anemia of chronic disease generally results from an infectious, inflammatory, or malignant process. However, in some reported cases, no such process could be identified. Differentiating iron deficiency anemia from anemia of chronic disease may be difficult because of similarities in presentation. physicians need to be aware of special clinical considerations when these two types of anemia coexist. Ferrous sulfate therapy is the ideal form of iron replacement.
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ranking = 0.99843168028671
keywords = blood loss
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3/25. Two cases of gastric antral vascular ectasia--response to medical treatment.

    Two patients with severe iron deficiency anemia and gastric antral vascular ectasia (GAVE) are reported. The anemia caused by the chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum was unresponsive to oral iron supplementation. However, one of the patients was successfully treated with intramuscular injection of (Asu1,7) eel calcitonin. The other one was treated by oral prednisolone with resulting improvement iron deficiency anemia. The possible mechanisms of successful calcitonin and prednisolone treatments on chronic blood loss from GAVE is discussed.
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keywords = blood loss
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4/25. gastric antral vascular ectasia.

    A case of gastric antral vascular ectasia confined to the antrum in an elderly Japanese male patient is described. The condition is a cause of blood loss and chronic iron deficiency anemia, particularly in the elderly. The clinical, endoscopic, and pathologic findings, which were contrasted with other hyperplastic or gastric vascular abnormalities, are described.
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keywords = blood loss
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5/25. gastric antral vascular ectasia associated with gastric carcinoma.

    gastric antral vascular ectasia (GAVE), or watermelon stomach, is an uncommon cause of chronic gastrointestinal blood loss and iron deficiency anemia. Although GAVE has not previously been reported in association with gastric cancer, it is often associated with atrophic gastritis and pernicious anemia, which are known risk factors for gastric malignancy. We report a 72-yr-old woman with pernicious anemia who was found to have GAVE associated with adenosquamous carcinoma of the gastric cardia and adenocarcinoma in situ of the pylorus. In view of recent reports of the use of endoscopic modalities rather than surgical resection to treat GAVE, our case alerts endoscopists to the possibility of coexisting carcinoma.
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keywords = blood loss
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6/25. malnutrition in a compulsive runner: a case conference.

    A 28-yr-old, female marathon and "fitness" runner presented with leg swelling, fatigue, and loss of endurance. She was running an hour or more daily in addition to regular biking and swimming. She was an instructor in a fitness center. For 2 months prior to her leg swelling, she had increased fatigue and decreased exercise tolerance. She had been seen previously for a slow healing hamstring strain. She had not had a menstrual period for over 2 yr and had refused evaluation. She admitted to very low dietary intake, which she had always denied. She was worried about her body fat. She denied recent blood loss, diuretic or cathartic use, and induced vomiting. She appeared malnourished, pale, and older than her stated age. Her weight was 41.4 kg. Her blood pressure was 90/60, and her pulse was 100 per minute. She had pitting edema of the lower extremities to the knees. The diagnosis of anorexia nervosa was made and will be discussed.
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keywords = blood loss
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7/25. gastric antral vascular ectasia (watermelon stomach)--therapeutic options.

    We have encountered five cases of chronic iron deficiency anaemia due to bleeding from gastric antral vascular ectasia (watermelon stomach). Two cases were associated with a lymphoma and in three cases there was evidence of portal hypertension. Two patients were treated conservatively by blood transfusions. The other patients required either surgery or tranexamic acid or endoscopic laser therapy to control the chronic haemorrhage.
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ranking = 0.0015683197132929
keywords = haemorrhage
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8/25. occult blood loss from small bowel tumours. Case report.

    We report 4 patients who presented with occult blood loss, from a small bowel adenocarcinoma, in whom there was considerable delay in diagnosis. The difficulty in diagnosis and the role of CT scanning is discussed. We recommend a careful laparotomy when endoscopic and radiological investigations fail to reveal the source of blood loss.
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keywords = blood loss
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9/25. Congestive gastroenteropathy--an extension of nonvariceal upper gastrointestinal bleeding in portal hypertension.

    Three cirrhotic patients with acute and chronic gastrointestinal blood loss are described. All had extensive gastric mucosal changes on endoscopy consistent with congestive gastropathy and also had extensive duodenal and jejunal changes consisting of multiple friable punctate areas of erythema. Two patients had esophageal varices from which bleeding could not be documented. The mucosal abnormalities seen in the small intestine of all three patients were similar to those within the stomach and are thought to represent an extension of congestive gastropathy and to be contributing to the blood loss. We propose that the term "congestive gastropathy" be replaced by a more comprehensive term, "congestive gastroenteropathy." The cause of these mucosal abnormalities remains unclear. Attempts at endoscopic therapy of these extensive abnormalities should be avoided until a greater understanding of the underlying pathophysiology is reached.
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ranking = 1.9968633605734
keywords = blood loss
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10/25. Iron management during recombinant human erythropoietin therapy.

    Treatment with recombinant human erythropoietin (r-HuEPO; EPOGEN [epoetin alfa], AMGEN Inc, Thousand Oaks, CA) rapidly corrects the anemia associated with end-stage renal disease during the acute phase of therapy and supports hematocrit levels throughout the maintenance phase. However, during the acute phase of therapy, iron deficiency will develop in most patients; it is therefore initially essential to monitor body iron stores monthly. A plasma ferritin level of less than 30 ng/mL or a transferrin saturation level of less than 20% confirms the diagnosis of iron deficiency. Microcytic, hypochromic red cell morphology appears only after prolonged iron deficiency due to inadequate monitoring and insufficient iron supplementation; alternatively, microcytosis in the presence of adequate iron stores suggests aluminum toxicity. In all patients except those with transfusional iron overload, prophylactic supplementation with ferrous sulfate (325 mg up to three times daily) is recommended. When oral supplements, which are poorly tolerated at high doses, are insufficient to meet the extraordinary needs resulting from r-HuEPO-induced erythropoiesis, intravenous iron dextran (500 to 1,000 mg administered in five to ten doses) may be required. During the maintenance phase of therapy, it may be necessary to continue iron supplementation to counteract ongoing loss of iron associated with blood loss through dialyzers and gastrointestinal bleeding. At the other extreme of iron balance, iron overload in transfusion-dependent patients, recent studies suggest that the ability of r-HuEPO to mobilize iron stores can be harnessed with therapeutic phlebotomy to reverse transfusional iron overload.
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keywords = blood loss
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