Abstract

ARPA GAMEZ, Ángel; ALVAREZ, Vladimir Felinciano; MORALES PERALTA, Margarita  and  TAMAYO RODRIGUEZ, Madelaine. Postgastrectomy anemia evolving to a myelodysplastic syndrome. Rev Cub Med Mil [online]. 2011, vol.40, n.3-4, pp. 295-301. ISSN 0138-6557.

This is a case presentation in which the etiological diagnosis of anemia must to be reviewed when appeared new clinical and hematological features and the patient don't respond anymore to the habitual treatment. The clinical case corresponds to a black man aged 63 admitted five years before due to a cerebrovascular disease as well as a post-grastrectomy iron-deficiency anemia according to study of peripheral blood and medullogram responding to treatment with i.m. ferrous fumarate. He is readmitted due to a neutropenia-associated severe anemia without response to treatment with iron and i.m. vitamin B₁₂ medullogram is repeated concluded that it is a refractory anemia. The iron-deficiency anemia is one of the more frequent diagnosed in the clinical practice. Gastrectomy if one of major causes and it requires a parenteral substitutive treatment. The refractory character appearing later in this patient aged over 60 leads to the presence of myelodysplasia syndrome specially if there are other associated cytopenias. Although the diagnosis of a anemia be appropriately based, the physician must to be able to assess other possibilities in face any evolutionary change, and no to persist in the initial diagnosis. In this case, the refractory character to treatment successful at onset and the association of other cytopenia, allowed us to suspect and to confirm a new entity.

Keywords : anemia; gastrectomy; myelodysplasia syndrome.