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4th March 2024
A 72-year-old female presents to her GP complaining of tiredness and shortness of breath.
A 72-year-old female presents to her GP complaining of tiredness and shortness of breath. This has started over the last 3 months and has slowly been getting worse. She has been getting 10 hours of sleep every night and denies any issues with her mood. The shortness of breath is worse during exercise. She denies any haemoptysis, weight loss or fevers.
She has a past medical history of vitiligo.
The GP requests some blood tests:
| Blood results | Reference Ranges | |
| Hb | 85 | 130-180 g/L |
| MCV | 110 | 76-96 fL |
| Platelets | 160 | 150-400 x109/L |
| WCC | 4.2 | 4-11 x1012/L |
| TSH | 3.2 | 0.5–5.7mU/L |
| B12 | 30 | >150 ng/L |
| Folate | 5 | 3 nmol/L |
| Ferratin | 80 | 12-200 μg/L |
| Anti-Intrinsic Factor Ab | 4.1 | <1.20 AU/mL |
| Anti-parietal cell Ab | 30 | <20 units |
| IgA-TTG | 1.1 | <11 U/mL |
Select the most appropriate treatment option for this patient:
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