26th July 2024

A 68-year-old man presents to A&E with a history of dyspnoea

A 68-year-old man presents to A&E with a history of dyspnoea. On examination you note he is visibly short of breath, has very pale skin and several bruises on his arms and torso. He has a background of myelofibrosis currently being managed with hydroxycarbamide. His bloods today are compared to the bloods from his last clinic appointment:


Today	Last clinic appointment
Hb 60 g/L (130-180) WCC 2.0 x 10⁹/L (4.0-11.0) Platelets 50 x 10⁹/L (150-400)	Hb 100 g/L (130-180) WCC 9.4 x 10⁹/L (4.0-11.0) Platelets 550 x 10⁹/L (150-400)

Today

Last clinic appointment

Hb 60 g/L (130-180)

WCC 2.0 x 10⁹/L (4.0-11.0)

Platelets 50 x 10⁹/L (150-400)

Hb 100 g/L (130-180)

WCC 9.4 x 10⁹/L (4.0-11.0)

Platelets 550 x 10⁹/L (150-400)

What is the most likely cause of this patient’s presentation today?

Select the SINGLE most appropriate option from the list below. Select ONE option only.