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An unusual case of chronic blood loss in the small intestine
  1. G Wurm Johansson,
  2. A Nemeth,
  3. J Nielsen,
  4. H Thorlacius,
  5. E Toth
  1. Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden
  1. Correspondence to Dr Gabriele Wurm Johansson, Skåne University Hospital, Department of Clinical Sciences, Endoscopy Unit, Entrance 44, plan 4, Malmö 205 02, Sweden; gabriele.wurmjohansson{at}skane.se

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Clinical presentation

A 62-year-old man presented with a 1-year history of fatigue and iron-deficiency anaemia. He had a history of ischaemic heart disease, chronic heart failure and hypertension. He reported normal appetite, normal bowel functions and denied weight loss. Physical examination revealed normal vital parameters, a non-tender abdomen without signs of organomegaly, and normal breathing sounds. Laboratory tests showed iron-deficiency anaemia with slightly decreased values of haemoglobin (115 g/l), mean corpuscular volume (MCV; 76 fl), ferritin (7.4 μg/l), iron (7 μmol/l), iron saturation (0.09), and increased levels of …

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