A case report of progressive anemia in the treatment of a patient with anxiety syndrome with somatic dicomfort as the core symptom
10.3760/cma.j.cn113661-20240919-00311
- VernacularTitle:以躯体不适为核心症状的患者治疗中出现进展性贫血1例
- Author:
Hairong LIAO
1
;
Jiaquan LIANG
1
Author Information
1. 佛山市第三人民医院 佛山市精神卫生中心，佛山 528000
- Publication Type:Journal Article
- Keywords:
Anxiety;
Anemia;
Physical disease;
Leukemia
- From:
Chinese Journal of Psychiatry
2025;58(7):549-552
- CountryChina
- Language:Chinese
-
Abstract:
Patients with anxiety disorders exhibit complex and diverse clinical manifestations, with symptoms showing significant overlap with somatic diseases. In clinical practice, relying solely on psychiatric symptoms and prioritizing anxiety disorders as the diagnostic pathway, while neglecting systematic evaluation of somatic symptoms and comprehensive analysis of auxiliary examinations could lead to missed or incorrect diagnoses, which may delay the appropriate treatment. This diagnostic dilemma is particularly evident in patients who have visited multiple general hospitals without identifying a clear somatic etiology before ultimately presenting to psychiatric services. This paper reports a case of a middle-aged patient who remained undiagnosed after multiple general hospital visits. The patient developed symptoms including anxiety, sleep disorders, nausea, and dysphagia due to working in a locked-down area. After failing to obtain a clear diagnosis, the patient was admitted to psychiatry department. While anti-anxiety therapy alleviated some symptoms, the patient subsequently developed progressive anemia, which was unresponsive to blood supplementation. Multidisciplinary Team consultation and bone marrow aspiration excluded anemia related to psychiatric medications and confirmed a diagnosis of acute myeloid leukemia. The patient achieved a favorable prognosis following bone marrow transplantation. This case highlights the importance of systematically differentiating between somatic and psychiatric symptoms in clinical practice.
