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.


General: Pale appearing woman in no acute distress. T 98.9°F, P 105, BP 94/64, RR 16.
Skin: Notable for several 2-3 cm ecchymoses on the forearms and thighs bilaterally; in addition, there is a petechial rash over the ankles and feet bilaterally.
HEENT: The oropharynx is notable for a small amount of fresh blood at the gum line around the base of multiple upper and lower incisors and molars.
CV: Normal S1, S2, regular, with a grade I/VI systolic murmur appreciated at the left sternal border.
Pulm: Unlabored respiration, clear to auscultation and percussion bilaterally.
Abd: Soft, non-tender, non-distended, without organomegaly or mass.
Extr: Warm, well perfused, no edema, but with the ecchymoses and petechiae noted above.
Neuro: Alert and oriented to person, place, and time. No motor or sensory defects.

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