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Revista Practica Medicala, Vol. XI, Nr. 4 (48), 2016
ISSN 1842-8258  |  e-ISSN 2069-6108
ISSN-L 1842-8258

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Differential diagnosis of iron deficiency anemia in a patient with chronic kidney disease and myasthenia gravis

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ABSTRACT
Background:
Iron deficiency anemia is the most common cause of anemia worldwide. The differential diagnosis of this entity remains one of the most encountered problems: from thalassemia, neoplasia, malabsorbtion syndrome to chronic kidney disease under hemodialysis.
Case report: This case report describes clinical and paraclinical features of a 75-year-old patient with multiple comorbidities and iron deficiency anemia. We emphasize on the importance of endoscopic videocapsule examination for the accurate diagnosis of iron deficiency anemia when other methods fail (endoscopy and colonoscopy), thus revealing the source of bleeding in a small bowel benign polyp. Thus, tumors of the small intestine present as a unique challenging diagnosis.
Conclusion: Endoscopic videocapsule, even if expensive, should remain an important tool in the diagnosis of iron deficiency anemia with normal upper GI endoscopy and colonoscopy. Small bowel tumors are seldom considered as a diagnostic hypothesis, but should not be overlooked, especially when alarm symptoms are present (weight loss, melena, hematochesia).

Keywords: anemia, videocapsule, small bowel, tumor

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