🔵 “Blue” Bone Marrow: Diagnostic Error and Unnecessary Invasive Procedure
🔬 A clinical case illustrating the importance of accurate anamnesis and the appropriateness of laboratory tests entered clinical practice.
👨⚕ Patient – a young man with severe weakness, weight loss (–6 kg in a month), nausea, and vomiting. 📉 Tests – severe anemia (Hb 39 g/L), leukopenia, and thrombocytopenia. ⚠ Preliminary suspicion – acute hematological disease. 🦴 Bone marrow puncture was performed – hypercellular bone marrow with megaloblasts was found.
❗ Outcome: diagnosis – pernicious anemia due to vitamin B12 deficiency. 🍃 The patient later reported that he was a strict vegetarian, but the B12 test was not initially performed, which led to unnecessary invasive diagnostics.
📌 Conclusion: ✅ Anamnesis collection – key to correct diagnosis. ✅ Correct choice of laboratory tests – prevents excessive interventions. ✅ B12 deficiency – a common problem in vegetarians, which can be detected by a simple blood test.
⚕ This case once again emphasizes how important it is to think, and not just order tests!
Source: Jani E., Roccaforte V., Daves M. The “Blue Marrow”: when inappropriateness in laboratory medicine leads to unnecessary invasive procedures—a case report //Journal of Laboratory and Precision Medicine. – 2024. – Т. 9.
