PANCYTOPENIA SECONDARY TO ? B12 DEFICIENCY

 This is online E-blog, to discuss our patient de-identified health data shared after taking her guardian's signed informed consent.




Here we discuss our individual patient problems through series of inputs from  available global online community of experts with an aim to solve the patients clinical problem with current best evidence based input.




This E-blog also reflects my patient's centred online learning portfolio. 

A 50 year old male patient working in a hotel ,came with complaints of 

Shortness of breath since 3months

Black coloured stools 2 episodes for one day 3 days back.

HOPI:

Patient was apparently asymptomatic 35years  back and then he developed involuntary moments of upper limbs and lower limbs(?Tonic and clonic moments)for 5 minutes ,and associated with drooling of saliva and loss of consiouness present at the time of those moments.No passage of urine and stools at the time of seizures.Following that episode he went to local hospital for which he was diagnosed as having epilepsy and then started using medication.After which he had 3 episodes of seizures with a gap of 15 days each and last episode was 34 years back.And he continued medication for 2years and stopped .And till now no seizure episodes and no other complications and  3months back  he developed shortness of breath which was present on exertion and which is insidious in onset and he developed black coloured stools for one day ,2 episodes moderate amount ,3 days back.

Not a known case of diabetes,hypertension,CVA,CAD.

Chronic alcoholic,since 30 years, stopped 3 months back.

GENERAL EXAMINATION:

Patient is c/c/c

Vitals:

BP:100/70mmHg

PR:80bpm

RR:16cpm

BAE presenr

CVS:S1 S2 present.No murmurs

CNS: NAD

Pallor +








No icterus,Cyanosis,clubbing,koilonychia,lymphadenopathy and edema.

Temp: Afebrile

















PROVISIONAL DIAGNOSIS:

Pancytopenia secondary to ?B12 deficiency 

Treatment given:

1)Inj.Nervigen 1amp in 100 ml NS IV OD



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