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Haematology query. The patient has rh. Arthritis since past many years. She was regularly taking daily diclofenac sr 100 mg, daily leflunomide 10 mg, weekly methotrexate 7.5 mg, along with pantop 40 mg in the morning & daily allopurinol 100 mg for gout. She has recently been diagnosed with duodenal ulcer & low hb (5 mg/dl). Before covid, her blood tests showed hb was 11 mg/dl. Her lft, rft normal now & previously. In 2019 serum iron 22 (50-170), tibc 232 (250- 425) & transferrin saturation 9.48% (15-50). Yet to repeat these now, but now hb 5, hematocrit 18.6, rbc count 3.14l, rdw 23.7%, mcv 60, mch 16, mchc 27.1 tlc, platelets normal (5.2l, 3.87l). Albumin 3.0, globulin 3.5 can you kindly tell if the previous findings point towards iron def anemia or something like anemia of chr dis? Now her crp is normal 0.70 (was high in 2019 - 40 mg/dl). After duodenal ulcer diagnosis, iron isomaltoside 5 ml infusion was given today, but any specific investigation or management from hematology pt of view?
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There is iron deficiency anemia based on the reports you shared. The methotrexate may also be contributing to the anemia. Do share all medication history with the treating physician.
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