01936nam a2200313 4500 ESSALUD 20260902162130.0 ta t pe ||||| |||| 00| 0 spa d BMG eng Ziperstein, Joshua C. 54484 Case 14-2026: A 50-year-old woman with vaginal bleeding and anemia páginas: 1940-1951 A 50-year-old woman was admitted to this hospital because of vaginal bleeding and anemia. The patient had been in her usual state of health, with leg edema that was attributed to chronic venous insufficiency, until 6 months before the current presentation, when increased swelling and new weakness developed in the legs. Before the onset of these symptoms, she had been physically active. She first noted that her legs felt more tired and sore than usual after normal physical activity, and the symptoms were accompanied by increased swelling and a feeling of heaviness in the legs. Over the course of the next 2 months, the leg weakness progressed to the point that she was unable to rise from a seated position or climb stairs. The patient also noted that her arms felt heavy, and she had difficulty reaching and holding them above her head. During this time, she had intermittent fever that resolved with the use of acetaminophen. ALERGIA 7055 INMUNOLOGÍA GENERAL 53664 ANEMIA 7417 REUMATOLOGÍA GENERAL 54450 ENFERMEDAD GLOMERULAR 54474 HEMATOLOGÍA 7422 ONCOLOGÍA GENERAL 54224 Barnawi, Rashid A. 54485 Al-Samkari, Hanny 54486 Bolster, Marcy B. 54487 Heusinkveld, Lauren E. 54488 22717 22669 Massachusetts NEJM Group NEJM014 The New England Journal of Medicine ESSALUD 0028-4793 ARTICULOS 2026-08-31 sqb 22906 22906