Name the Diagnosis in 2 Words

QUESTION: Name the diagnosis in 2 words.

ANSWER: The correct answer is pernicious anemia. Let’s approach the case from the perspective of pancytopenia (see graphic for classification). What do we know from the data?

• The abnormalities are acquired
• The abnormalities were quickly reversed

These features help to narrow the ddx down to alcohol toxicity (though significant anemia not usually a feature), vitamin B12 deficiency (which includes pernicious anemia as a cause) and the rare case of liver transplantation (the MCV corrects immediately but not the counts).

I asked for a diagnosis in 2 words, so the possibilities in descending order of likelihood are:

• Pernicious anemia
• ETOH toxicity (but the MCV takes months to correct and this degree of anemia is uncommon)
• Liver transplant (not quite the right timing for recovery)

For video explanation, click here.