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A 77-year-old man was admitted to the hospital with a three-week history of nausea, vomiting, pain in the right upper quadrant, and fever with chills. Laboratory studies showed that the white-cell count was 6400 per cubic millimeter, the hemoglobin concentration was 9.0 g per deciliter, the hematocrit was 26.5 percent, the platelet count was 255,000 per cubic millimeter, and the reticulocyte count was 0.6 percent. To evaluate the patient's anemia further, a bone marrow examination was performed; it revealed mild hypercellularity with trilineage hematopoiesis but with a reduced number of erythroid precursors. Evaluation of a smear of the bone marrow . . . [Full Text of this Article] |