Today we talked about an interesting case of a patient with cirrhosis (presumably alcohol and hepatitis C related) who presented with ascites, confusion, and anemia.
Cirrhosis (including approach to ascites and SBP) previously blogged here and here
Upper GI bleeding previously blogged here, here, and here.
Anemia previously blogged here and here (macrocytic anemia).
NB: One of the key teaching points in this case is that "iron deficiency anemia" is a not a diagnosis until you understand *why* the patient has iron deficiency. Are they not eating iron, not absorbing iron, losing iron (bleeding or losing in the urine in intravascular haemolysis)?
In people with no evidence of occult blood loss in the GI tract and no other evident losses, you should consider the diagnosis of celiac disease.
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