Case report 1

A 45-year-old woman presented to the clinic with a chief complaint of persistent fatigue, weakness, and difficulty performing her daily activities for the past six months. Upon further inquiry, the patient revealed a history of irregular menstrual cycles and heavy menstrual bleeding during this period. She also reported experiencing shortness of breath and occasional palpitations, especially when exerting herself. Despite these symptoms, she did not experience any episodes of fainting or loss of consciousness. The patient mentioned that she had been noticing leg cramps and had developed an unusual craving for chewing on ice cubes. She denied any fever, drug use, or abdominal discomfort. However, she did admit to a decreased appetite, consuming only one meal a day. During the physical examination, it was noted that the patient appeared pale and fatigued. Additional findings included tachycardia, pale conjunctiva, pale nail beds, and an enlarged tongue. These observations raised concerns about a possible underlying condition. Laboratory results revealed a Red Blood Cell Count (RBCs) of 3.6 million/mm3, a Hemoglobin level of 8.2 g/dL, and a Hematocrit measurement of 28%. The Mean Corpuscular Volume (MCV) was notably reduced at 62 fL. The Total Iron Binding Capacity (TIBC) measures 255 μg/dL. Other relevant blood parameters included a red cell distribution width of 19.6%, a white blood cell count of 5.3 × 109/L, and a platelet count of 439 × 109/L.