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Case Records of the Massachusetts General HospitalFree Preview

Case 14-2021: A 64-Year-Old Woman with Fever and Pancytopenia

List of authors.
  • Michael D. Gibbons, M.D.,
  • Dexter P. Mendoza, M.D.,
  • Anem Waheed, M.D., M.P.H.,
  • Miriam B. Barshak, M.D.,
  • and Julian A. Villalba, M.D.

A 64-year-old woman with multiple sclerosis was admitted with fever and pancytopenia after a 7-month illness that began with nausea and fatigue. CT revealed splenomegaly; FDG-PET revealed uptake in the spleen and bone marrow throughout the axial and appendicular skeleton. A diagnostic test result was received.

Funding and Disclosures

This case was presented at the Medical Case Conference.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Dr. Barshak reports owning stock in Pfizer, Boston Scientific, and Viatris. No other potential conflict of interest relevant to this article was reported.

We thank Dr. Aliyah R. Sohani for review of the hematology discussion, Dr. Walter H. Dzik for review of the transfusion medicine discussion, and Dr. John A. Branda for review of the pathology discussion.

Author Affiliations

From the Department of Medicine, Newton-Wellesley Hospital, Newton (M.D.G.), and the Departments of Radiology (D.P.M.), Medicine (A.W., M.B.B.), and Pathology (J.A.V.), Massachusetts General Hospital, and the Departments of Radiology (D.P.M.), Medicine (A.W., M.B.B.), and Pathology (J.A.V.), Harvard Medical School, Boston all in Massachusetts.

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