Related Experiment Video
Updated: May 19, 2026

A Point-of-Care Method with Integrated Decision Support Tool to Estimate Anemia at Population Level
Published on: January 19, 2024
[Pronounced pancytopenia with concomitant jaundice in a 66-year-old woman]
V Kächele1, W Schneider-Kappus, M Bommer
1Hämato-Onkologische Praxis Ulm. volker.kaechele@gmx.de
History And Admission Findings:
A previously healthy 66-year-old women presented with onset of general weakness, shortness of breath and significant weight loss. Due to appearance of jaundice, biliary obstruction had been ruled out by a CAT scan previous to the patients presentation in our practice.
Investigations:
The laboratory tests already arranged by the patients general practitioner showed a pronounced pancytopenia with megaloblastic anemia and hyperbilirubinemia. The bone marrow aspiration revealed a hypercellular bone marrow with megaloblastic erythropoiesis. The diagnosis of pernicious anemia was confirmed by the low cobalamin (vitamin B12) serum level and the presence of atrophic gastritis.
Treatment:
Pernicious anemia was treated with intramuscular injection of Cyanocobalamin (1000 µg) which resulted in an immediate reticulocytosis and a widely normalized blood cell count and bilirubin level four weeks after initiation of treatment.
Conclusion:
The differential diagnosis of megaloblastic anemia covers a wide spectrum of diseases with different etiology. This case report demonstrates an example of a pernicious anemia with atypical and foudroyant clinical course.
Related Concept Videos
Jaundice
Chronic Kidney Disease II: Clinical Manifestations
Type I Diabetes III: Clinical Manifestations
Changes in Skin Color: Clinical Perspectives
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Chronic Pancreatitis II: Pathophysiology
Chronic Pancreatitis I: Introduction