EDITOR'S QUIZ: GI SNAPSHOT

Postprandial abdominal pain, megaloblastic anaemia, and severe weight loss in an 80 year old man

A U Dignass, M E Pascu, A B Roznowski, B Wiedenmann

Department of Internal Medicine, Division of Hepatology and Gastroenterology, Charité Medical School-Campus Virchow Clinic, Berlin, Germany

Correspondence to:
Correspondence to:
Dr M E Pascu
Charité Universitätsmedizin Berlin-Campus Virchow, Medizinische Klinik m S Hepatologie und Gastroenterologie, Augustenburger Platz 1, 13353 Berlin, Germany; axel.dignass@charite.de

Keywords: abdominal pain; megaloblastic anaemia; weight loss

The first 150 words of the full text of this article appear below.

An 80 year old man with no previous medical history was referred to our hospital with progressive weight loss of 24 kg in the past 12 months. There were no episodes of diarrhoea, fever, night sweats, nausea, or vomiting in the past 12 months. Physical examination revealed a significant reduction in the patient’s general and nutritional status (weight 56 kg, size 178 cm, body mass index 17.6 kg/m²), symmetrical oedema of the forearms and lower legs, and pleural effusions. Pathological laboratory findings included: erythrocyte sedimentation rate 82 mm/h; C reactive protein 3.8 mg/dl (normal 0.8 mg/dl); serum protein 5.6 g/dl (normal 6.5–8.5 g/dl); serum albumin 1.8 g/dl (normal 3.6–5.0 g/dl); serum iron 3.3 µmol/l (normal 10.6–26.0 µmol/l); haemoglobin 10.7 g/dl (normal 14–18 g/dl); MCV 119.7 fl (normal 86–101 fl); and vitamin B₁₂ 74 pg/ml (normal 199–730 pg/ml). Computed tomography scans of the chest and abdomen showed symmetrical pleural effusions . . . [Full text of this article]

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