[9th Decade Female with Dementia, Who Had Anemia Pointed Out on a Routine Laboratory Check]

Area of Science:

• Hematology
• Oncology
• Geriatric Medicine

Background:

• A case report from the 63rd Japanese Society of Laboratory Medicine congress.
• Focuses on a 9th-decade female patient with dementia and routine anemia detection.

Observation:

• Patient presented with macrocytic anemia (MCV > 130 fL) and decreased Vitamin B12/folate levels.
• Anemia parameters improved with supplementation, but White Blood Cell (WBC) count increased.
• Initial diagnosis suggested a neoplastic hematological disorder.

Findings:

• The final diagnosis was acute myeloid leukemia (AML-M4).
• Massive infiltration of neoplastic cells led to spleen rupture.
• The patient died due to complications of the leukemia.

Implications:

• This case underscores the importance of thorough hematological evaluation in elderly patients with unexplained anemia.
• Highlights the diagnostic challenges in complex cases, especially with limited data.
• Emphasizes the aggressive nature of certain leukemias and their potential for fatal complications.