Case 40. Misdiagnosis of refractory macrocytic anemia

Abstract

A diagnosis of myelodysplastic syndrome, refractory anemia subtype, was made in an elderly Indian woman on the basis of a refractory macrocytic anemia with normal vitamin B₁₂ and folate assays, normal thyroid function, essentially normal liver function and normal cytogenetic analysis. Disease evolution revealed that the diagnosis was erroneous.

Keywords:

• Myeloid leukemias and dysplasias
• neoplasia erythrocytes
• hematopoiesis
• autoimmunity: responses to self-antigen
• immunobiology, megaloblastic anemia, vitamin B12 deficiency