A Patient with Pancytopenia

Peter W. Marks, MD

Yale University School of Medicine, New Haven, CT

Copyright of the American Society of Hematology, 2012. ISSN: 1931-6860.



A 34 year-old woman is seen by her dentist for bleeding from her gums. The bleeding started on the day prior to evaluation and seems to be getting steadily worse with time.

After briefly evaluating the patient and noting diffuse bleeding from the mucosal surfaces around multiple teeth, the dentist refers her for further evaluation to the emergency department at a nearby hospital where you are working.

What further information should you request regarding the patient's history?

Have you ever had a similar episode in the past?
Is there any family history of a bleeding disorder?
Are you taking any prescribed or over-the-counter medications?
Do you smoke cigarettes or drink alcohol?
Do you have any bruises or other areas of bleeding?
Is anyone else in your family ill?
Do you have any pets?


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