01805nam a2200265   4500001000800000005001700008007000300025008004100028040000800069041000800077100002900085245005400114300002500168520108400193650001101277650001801288650001901306650001601325650001501341700001701356700002001373700001901393700002401412773010301436ESSALUD20260805101914.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aAird, William C. eAutor  aCase 17-2026: A 74-Year-Old Man with Pancytopenia  apáginas: 2357-2368  aA 74-year-old man was admitted to this hospital because of persistent pancytopenia that had resulted in multiple red-cell transfusions. Three months before the current presentation, the patient underwent heart transplantation after a prolonged admission in the cardiac intensive care unit of this hospital. He had been admitted for decompensated heart failure due to transthyretin amyloid cardiomyopathy, for which he received treatment with infusions of inotropic and diuretic agents. The preoperative course was notable for anemia, for which he received intravenous iron therapy. In addition, the patient had persistent thrombocytopenia that prompted a switch in treatment from heparin to a direct thrombin inhibitor, despite the fact that testing for antibodies against platelet factor 4 was negative. Serologic testing performed before transplantation was positive for Epstein–Barr virus (EBV) IgG, negative for cytomegalovirus (CMV) IgG, and negative for toxoplasma IgG. Serologic testing in the donor was positive for EBV IgG and CMV IgG and negative for toxoplasma IgG.   aANEMIA  aCARDIOLOGÍA  aCARDIOMIOPATIA  aMIOCARDITIS  aTRASPLANTE  aVan-Khue Ton  aSultana, Sadia   aAzar, Sharl S.  aKotton, Camille N. 0 022717dMassachusetts NEJM GroupoNEJM007tThe New England Journal of Medicine wESSALUDx0028-4793