Profound anaemia and thrombocytosis due to hidradenitis suppurativa

This case presents a woman in her late 50s with hidradenitis suppurativa (HS) who presented for weight loss, syncope and dyspnoea. Labs revealed severe microcytic anaemia, thrombocytosis and leucocytosis. Despite initial uncertainties, further investigation pointed towards multifactorial anaemia suspected from iron deficiency and chronic inflammation associated with HS. Differential diagnoses included malignancy, heart failure, pulmonary embolism and gastrointestinal bleed-related anaemia, which were ruled out through comprehensive examinations. The treatment involved systemic steroids, doxycycline and adalimumab for HS, along with blood transfusions and iron supplementation for anaemia. Follow-up showed significant improvement in symptoms and laboratory results, affirming the efficacy of the treatment regimen. This discussion demonstrates the profound haematologic derangements that can occur in severe HS. Although the precise aetiology of anaemia in HS is sometimes ambiguous, managing both conditions concurrently is crucial, given their impact on patient outcomes and healthcare costs.