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A premenopausal woman with abdominal discomfort and iron deficiency anaemia

By: Contributor(s): Publication details: 2015Uniform titles:
  • BMJ
Online resources: Summary: <span style="font-family: FreeSerif; font-size: 10pt;"></span><p align="left"><span style="font-family: Arial;">A 48 year old premenopausal woman presented to our clinic <span>with a 12 month history of intermittent abdominal discomfort <span style="font-family: Arial;"><span>associated with bloating, constipation, and weight loss of 6.3 <span>kg. Her medical history included chronic iron deficiency <span style="font-family: Arial;"><span>anaemia, vitamin D deficiency, and episodes of fresh rectal <span>bleeding caused by haemorrhoids, which required sclerotherapy. <span style="font-family: Arial;"><span>She had undergone a diagnostic laparoscopy for abdominal <span>pains, which did not detect any abnormalities. There was no <span style="font-family: Arial;"><span>family history of colorectal cancer. On examination she looked <span>well, weighed 50 kg, with a body mass index of 20. Her <span style="font-family: Arial;"><span>abdomen was soft, non-tender, and without palpable masses. <span>The results of a digital rectal examination were normal. Routine <span style="font-family: Arial;"><span>blood tests showed iron deficiency anaemia, with haemoglobin <span>109 g/L (reference range 117-155), mean corpuscular volume <span style="font-family: Arial;">80.6 fL (80-100), mean corpuscular haemoglobin 27.3 pg/cell <span style="font-family: Arial;">(27-33), and ferritin 4 ng/mL (10-232).</span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></p><span style="font-size: 10pt;">&nbsp;</span>
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&lt;span style="font-family: FreeSerif; font-size: 10pt;"&gt;&lt;/span&gt;&lt;p align="left"&gt;&lt;span style="font-family: Arial;"&gt;A 48 year old premenopausal woman presented to our clinic &lt;span&gt;with a 12 month history of intermittent abdominal discomfort &lt;span style="font-family: Arial;"&gt;&lt;span&gt;associated with bloating, constipation, and weight loss of 6.3 &lt;span&gt;kg. Her medical history included chronic iron deficiency &lt;span style="font-family: Arial;"&gt;&lt;span&gt;anaemia, vitamin D deficiency, and episodes of fresh rectal &lt;span&gt;bleeding caused by haemorrhoids, which required sclerotherapy. &lt;span style="font-family: Arial;"&gt;&lt;span&gt;She had undergone a diagnostic laparoscopy for abdominal &lt;span&gt;pains, which did not detect any abnormalities. There was no &lt;span style="font-family: Arial;"&gt;&lt;span&gt;family history of colorectal cancer. On examination she looked &lt;span&gt;well, weighed 50 kg, with a body mass index of 20. Her &lt;span style="font-family: Arial;"&gt;&lt;span&gt;abdomen was soft, non-tender, and without palpable masses. &lt;span&gt;The results of a digital rectal examination were normal. Routine &lt;span style="font-family: Arial;"&gt;&lt;span&gt;blood tests showed iron deficiency anaemia, with haemoglobin &lt;span&gt;109 g/L (reference range 117-155), mean corpuscular volume &lt;span style="font-family: Arial;"&gt;80.6 fL (80-100), mean corpuscular haemoglobin 27.3 pg/cell &lt;span style="font-family: Arial;"&gt;(27-33), and ferritin 4 ng/mL (10-232).&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/span&gt;&lt;/p&gt;&lt;span style="font-size: 10pt;"&gt;&amp;nbsp;&lt;/span&gt;

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