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November 1984

Severe Bleeding Complicating Percutaneous Bone Marrow Biopsy

Arch Intern Med. 1984;144(11):2284. doi:10.1001/archinte.1984.04400020218045

To the Editor.—A 78-year-old man was admitted for the evaluation of anorexia and weight loss of three weeks' duration. Physical examination showed a pale patient with slight dyspnea, regular pulse rate of 92 beats per minute, and blood pressure of 170/100 mm Hg. Crepitant rales were heard over both lungs, and the liver was palpated 2 cm below the costal margin. Rectal examination revealed an enlarged prostate. Laboratory studies disclosed the following values: hemoglobin, 11 g/dL with macrocytic indexes; ESR, 90 mm/hr (Westergren); serum alkaline phosphatase, 168 IU/L; calcium, 2.4 mmole/L; and phosphorus, 1.04 mmole/L. The total acid phosphatase level was elevated (16 IU), while the prostatic portion was normal. Protein was undetectable in the

A bone marrow aspirate yielded "dry tap." Therefore, a bone mar[ill] biopsy was performed from the p[ill]terosuperior iliac spine. While [ill] Jamshidi needle1 was introduced, friable bony tissue was felt. As [ill] guide of the

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