Case 33-2007 -- A 49-Year-Old HIV-Positive Man with Anemia

doi:10.1056/NEJMcpc079027

Volume 357:1745-1754		October 25, 2007		Number 17

Case 33-2007 — A 49-Year-Old HIV-Positive Man with Anemia

Eyal C. Attar, M.D., Suzanne L. Aquino, M.D., and Robert P. Hasserjian, M.D.

Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

A 49-year-old man infected with the human immunodeficiency virus(HIV) was seen in the hematology clinic at this hospital forevaluation of anemia.

Five weeks earlier (1 week before a routine follow-up visitwith his infectious-disease specialist), laboratory testingshowed anemia (Table 1). Treatment with iron and multiple vitaminswas initiated, and the patient was referred for hematologicevaluation.

View this table:

Table 1. Results of Laboratory Tests.

HIV infection had been diagnosed approximately 20 years earlier,and he was followed by an infectious-disease specialist at thishospital. Eleven months earlier, the patient had discontinuedantiretroviral therapy because of lipoatrophy, hyperlipidemia,and "pill . . . [Full Text of this Article]

Differential Diagnosis

Blood Loss or Hemolysis

Deficiencies of Red-Cell Production

HIV Infection

Pure Red-Cell Aplasia

Pathological Discussion

Dr. Eyal C. Attar's Diagnosis

Pathological Discussion

Discussion of Management

Anatomical Diagnosis

Source Information

From the Hematology–Oncology Unit (E.C.A.) and the Departments of Radiology (S.L.A.) and Pathology (R.P.H.), Massachusetts General Hospital; and the Departments of Medicine (E.C.A.), Radiology (S.L.A.), and Pathology (R.P.H.), Harvard Medical School.