Paul K. Schick, MD

Professor of Medicine, Emeritus, Thomas Jefferson Medical College, Philadelphia
Research Professor, Drexel University College of Medicine, Philadelphia
Adjunct Clinical Professor, Lankenau Hospital (LIMR), Wynnewood, PA

This case was reviewed and updated in September 2012 by Dr. Peter Marks and members of the Teaching Cases Subcommittee.

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.



A 45-year-old white female seeks medical attention for fatigue that developed during the last month. She also feels mildly short of breath with exertion such as walking up a flight of stairs, but she has no chest pain with exertion or at rest. She notes no bright red blood per rectum or melena, but she has had heavy menstrual periods for about a year.

Past medical history: She was treated for anemia following her third pregnancy 10 years ago. She has not been taking any prescribed medications.

Family history: Her parents were born in Italy and died when she was in grade school. She does not know their medical history.

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