Colleagues, this is a real case. A patient from the Republic of Mari El (Yoshkar-Ola) contacted me for online assistance. If there are any hematologists/oncologists here from public departments in this republic or nearby cities (Kazan, Cheboksary), please provide assistance under the compulsory medical insurance program. Let’s discuss why colonoscopy, Ferinject, and peripheral blood immunophenotyping in a private laboratory are prescribed based on these complete blood count data.
Male, 56 years old. According to the patient: “History of osteosarcoma of the knee at 14 years old. At 48 years old, back pain, pleomorphic sarcoma of the retroperitoneal space was found. Chemotherapy and radiotherapy, full course. For 7 years, nothing bothered me. Every six months, I was examined by an oncologist, alternating ultrasound and CT scans. Before each visit to the oncologist, blood tests were taken; the result of the last test came back bad. My teeth hurt, they were extracted. I feel good, sometimes dizziness, shortness of breath. Hematologist consultation: diagnosis of pancytopenia of unknown origin. Oncologist consultation: everything is clear, lymph nodes are normal, no data on sarcoma. Ferinject (?) was prescribed to raise hemoglobin, colonoscopy, and immunophenotyping (to rule out CLL, ALL, lymphomas) in a private laboratory. The test is very expensive, 14 thousand; is it mandatory to do it? Regarding bone marrow aspiration, they say it’s excluded, only phenotyping. Inpatient care is refused.”
