first,I would like to say it is an honor to join such anice dialogue forum.
I faced a-31 years old female single patient complaining of recurrent red cell anaemia(low Hb)that necicitates multiple repeated blood transfusions,&here is whole story:
problem get started 2years back when she got a rickettsial infection manifested in purpuric rash in both palms&soles,spleenomegaly,admitted to infectous department &managed there ,no document regarding receiving a-chloramphicol,few months later spleenectomy was done for here probably on basis of hypersplinism,soonafter, she was presented with severe dyspnea&diagnosed to have a-pericardial effussion that is treated,here suspesion raised about SLE but workup was totally free,
thymoma is ruled out,bone marrow aspirate showed hypoplastic picture with low erythroid &normal other cell lines,no atypical cells were found.
usual Hb is 4%,2.9g% but with changing ESR.
WHAT COULD BE THE CAUSE.