Hematology Case Histories - Case 9

A 14-year-old girl complained of fatigue and loss of stamina. Her appetite was marginal, as she was very conscious of maintaining her body weight at 96 pounds. Her monthly menstrual flow was always heavy and long from its onset at twelve years of age. Relevant laboratory findings included the following:

Hematocrit (Hct) 28%
Hemoglobin (Hgb) 9 g/dL
Iron 16 µg/dL
Bone marrow iron Absent
Erythrocytes Small and pale

Suggested treatment included ferrous sulfate or ferrous gluconate for six months orally between meals, since food may reduce absorption. A well-balanced diet was also suggested, as well as a gynecological examination.

1. What is the primary disorder of this individual?

2. What does the ferrous sulfate or ferrous gluconate provide? Why is it necessary?

3. What dietary inclusions would you suggest?

4. Why is the gynecological examination important?

5. Why is bone marrow iron an important clinical indicator in this individual?

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