Kapil Saxena, MD; Khoan Vu, MD; Heather E. Nye, MD, PhD
free access
JAMA. 2019;321(9):895-896. doi:10.1001/jama.2018.21899
A 54-year-old man who had undergone Roux-en-Y gastric bypass 12 years ago presented for evaluation of new-onset pancytopenia. Histopathologic examination of bone marrow aspirate showed normocellular marrow, dyserythropoiesis with vacuolized and dysplastic erythroid precursors, left-shifted granulocytic maturation, ring sideroblasts with no increase in blasts, and no cytogenic abnormalities. What would you do next?