Mr RK ,68y,M,fell down and became unconscious one day while at outdoor park one cold morning. He gained concsiouscness in few minutes. There was no H/o convulsions. No h/o head injury, No H/O weakness of limbs.
He is nondiabetic , nonhypertensive and non-smoker. He was taken to doctor and was investigated. Only positive finding was HB-6.5Gm%.GBP-Normocytic normochromic. His s iron was normal.
He had no H/O of haemoroids or GI bleed. He was put on oral iron but his Hb did not improve in 15 days. He was given IV iron and IV B12 but showed no sign of improvement. He was labelled as a case of Refractory anaemia and was investigated for any underlying malignancy .No malignancy was found but his Hb did not rise. He was bought to me.
O/E Pulse-76/Min,regular,BP-130/90mm, Pallor-+,Cyanosis-nil.
Sys examination-NAD
Key- H/O lethargy and gaining Wt + Coarse facial features
INVESTIGATION-THYROID PROFILE
RESULT-TSH-128IU
DIAGNOSIS- HYPOTHYROIDISM
LESSON- HYPOTHYROIDISM IS A CAUSE OF REFRACTORY ANAEMIA
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