TY - CHAP M1 - Book, Section TI - DISORDERS OF PORPHYRIN METABOLISM A1 - Hillman, Robert S. A1 - Ault, Kenneth A. A1 - Leporrier, Michel A1 - Rinder, Henry M. Y1 - 2016 N1 - T2 - Hematology in Clinical Practice, 5e AB - CASE HISTORY • Part 1A 45-year-old housepainter presents with several weeks of worsening abdominal pain, headache, insomnia, and difficulty gripping his paint brush. His past history and review of systems (ROS) is positive for smoking, alcoholism, and reactive depression. Vital signs: BP - 165/95 mm Hg, P - 84 bpm, R - 16 bpm. Examination is positive for grayish staining of the gum line, hepatomegaly, diffuse abdominal tenderness without rebound, and 2+ weakness of wrist extensors bilaterally.CBC: Hematocrit/hemoglobin - 36%/12 g/dLMCV - 87 fL MCH - 30 pg MCHC - 31 g/dLRDW-CV - 12%WBC count - 6,500/μLPlatelet count - 160,000/μLSMEAR MORPHOLOGYNormocytic and normochromic red cells, a few hypochromic cells, and occasional "shift cells" with questionable stippling. Normal white blood cell and platelet morphology.Reticulocyte count/index - 4%/1.5–2.0QuestionsWhat condition(s) is suggested from this presentation and complete blood count (CBC) findings?What additional history and laboratory tests are needed to confirm the diagnosis? SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/28 UR - hemonc.mhmedical.com/content.aspx?aid=1127766609 ER -