RT Book, Section A1 Hillman, Robert S. A1 Ault, Kenneth A. A1 Leporrier, Michel A1 Rinder, Henry M. SR Print(0) ID 1127765178 T1 CLINICAL APPROACH TO ANEMIA T2 Hematology in Clinical Practice, 5e YR 2016 FD 2016 PB McGraw-Hill Medical PP New York, NY SN 9780071626996 LK hemonc.mhmedical.com/content.aspx?aid=1127765178 RD 2024/10/09 AB CASE HISTORY • Part 1A 48-year-old man with poorly controlled type 1 diabetes is referred for evaluation of a worsening anemia. He reports a long-standing history of general fatigue and poor exercise tolerance, which he feels have worsened of late. Complications of his diabetes include severe retinopathy, peripheral vascular disease with one flight claudication, and worsening neuropathy. On physical examination, he appears chronically ill with a sallow complexion and pale conjunctiva. Findings include bilateral retinal hemorrhages, diminished pulses, and impaired sensation and position sense in both feet.CBC: Hematocrit/hemoglobin - 29%/9.5 g/dL (IU - 95 g/L)MCV - 91 fL MCH - 30 pg MCHC - 33 g/dLRDW-CV - 13.5%RDW-SD - 48 fLWBC count - 8,800/μLPlatelet count - 150,000/μLSMEAR MORPHOLOGYNormocytic and normochromic with minimal anisocytosis and no polychromasia. White cell and platelet numbers and morphology appear to be within normal limits.Reticulocyte count/index - 2.0%/1.2Sedimentation rate - 30 mm/h (Westergren)QuestionsHow should this anemia be described?What physiological factors may be playing a role?Are there other tests that can be ordered to find the cause?