Abstract
An healthy 74-year-old aboriginal man presented with a 2-month history of intermittent melena and epistaxis. Initial symptoms were dizziness, pallor and dyspnea on exertion. He was taking neither antiplatelet drugs nor anticoagulants. Physical examination was unremarkable, except for pale conjunctivae and sinus tachycardia (heart rate 130 beats per minute). Laboratory evaluation revealed anemia [hemoglobin, 6.8 g/dL (normal, 11.5–15.0 g/dL)] and prerenal azotemia [blood urea nitrogen, 45mg/dL (5–22mg/dL) and creatinine 1.7mg/dL (0.5–1.3mg/dL)].
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