Case 18-1961

Abstract

Presentation of Case First admission. A sixty-one-year-old woman entered the hospital because of dyspnea and weakness.During the year before admission she experienced slowly increasing dyspnea and fatigue. Seven months before entry x-ray films of the chest, an upper gastrointestinal series and an electrocardiogram were normal. The hemoglobin was 50 per cent. She was treated with iron, "liver shots," vitamin B12 and folic acid, without demonstrable effect. There was no history of exposure to toxic agents. Subsequently, an occasional slight epistaxis occurred. There were stinging pains in the anterior portion of the left thigh that radiated to the calf . . .