A presentation of myelodysplasia
Case scenario
Bill, aged 59 years, is a nonsmoker and has, on average, six to eight drinks on four days of each week. He has had hypertension, hypercholesterolaemia and osteoarthritis at least since he first attended your practice two years ago, and has recently developed gout. He takes intermittent colchicine and regular allopurinol for his gout, and is also taking indomethacin, irbesartan and hydrochlorothiazide. There is no recent history of fever or infections, and although he has plethoric facies there are no notable physical findings.
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