Salomo, Louise1; Salomo, Morten2; Andersen, Steven A W3; Kamper, Anne-Lise1
1 Department of Nephrology, Abdominal Centre, Rigshospitalet, The Capital Region of Denmark2 Hæmatologisk Klinik, Finsencentret, Rigshospitalet, The Capital Region of Denmark3 Øre-næse-halskirurgisk og Audiologisk Klinik, HovedOrtoCentret Rigshospitalet, Rigshospitalet, The Capital Region of Denmark
A 32-year-old man was admitted to the hospital because of oedema and 8 kg of gained weight. The oedema decreased spontaneously over weeks and there was no evidence for a nephrotic syndrome; however, the blood tests revealed a moderate pancytopenia. The patient practiced excessive physical activity at work and in his spare time, and kept a very thorough training and weight diary. Owing to a high intake of energy and protein drinks he tried to optimise his physical performance and kept a normal body mass index at 23.7. A bone marrow biopsy showed gelatinous bone marrow transformation, normally seen in critically ill patients or those with severe malnutrition. In this case, the cause is presumed to be excessive physical activity/overtraining in combination with relatively insufficient nutrition.