A 53-year-old man with a past medical history significant for coronary artery disease presented with worsening weakness and exertional dyspnea over a period of 1 week.
The patient also reported paresthesia in his hands and feet bilaterally. Pertinent laboratory data included the following values: hemoglobin, 9.5 g/dL; white blood cell (WBC) count, 3000/µL; vitamin B12, less than 31 pg/mL; lactate dehydrogenase (LDH), 2520 U/L; and haptoglobin, less than 10 mg/dL. Schistocytes, polychromasia, and few platelets were identified on a peripheral smear.
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