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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 339:329-337 July 30, 1998 Number 5
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Case 24-1998— A 76-Year-Old Woman with Cardiac and Renal Failure and Gastrointestinal Bleeding
John B. Wong, and Carolyn C. Compton

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Presentation of Case

A 76-year-old woman was admitted to the hospital because of gastrointestinal blood loss and worsening anemia.

The patient had a long history of hypertension with mild azotemia and asymptomatic idiopathic thrombocytopenia. Eight weeks before the current admission, she was admitted to the hospital because of worsening congestive heart failure, which improved with diuretic medication. Laboratory examination showed a hematocrit of 32.3 percent and a platelet count of 79,000 per cubic millimeter. The urea nitrogen level was 31 mg per deciliter (11 mmol per liter), and the creatinine level was 3.7 mg per deciliter (330 µmol per liter). A test for . . . [Full Text of this Article]

Differential Diagnosis

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Dr. John B. Wong's Diagnosis

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