A 28 year old woman presents with fatigue, frequent nosebleeds, and recurrent infections. She recently completed chloramphenicol therapy abroad. Examination shows scattered petechiae but no lymphadenopathy or splenomegaly. Laboratory studies reveal pancytopenia and a very low reticulocyte count. Bone marrow biopsy shows marked hypocellularity with fatty replacement. Which of the following is the most likely diagnosis?
- A)Acute myeloid leukemia
- B)Aplastic anemiaGABARITO
- C)Paroxysmal nocturnal hemoglobinuria
- D)Multiple myeloma
- E)Myelofibrosis
Explicação
Aplastic anemia is correct. This patient has pancytopenia with hypocellular marrow and absent splenomegaly, consistent with bone marrow failure. Drugs, radiation, viruses, and autoimmune destruction of hematopoietic stem cells are classic causes. Ver explicação completa e trilha adaptativa →