Yes
Case Report. An 82-year-old woman presented to the hospital with confusion and lethargy. Upon arrival, she was experiencing bradycardia, hypothermia, and severe respiratory stridor. She did not report any chronic signs or symptoms of hypothyroidism. Past medical history was unremarkable; she was on no medications. Differential diagnosis can be regarded as implementing aspects of the hypothetico-deductive method, in the sense that the potential presence of candidate diseases or conditions can be viewed as hypotheses that physicians further determine as being true or false. The differential diagnostic procedure may be simplified if a ' pathognomonic ' sign or symptom is found (in which case it is almost certain that the target condition is present) or in the absence of a sine qua non sign or symptom (in which case it is almost certain that the target condition is absent). In a nursing-home study categorizing anemia of chronic inflammation as the presence of an inflammatory comorbid condition, the mean CRP was 36.9 mg/dL for those with anemia of chronic inflammation, compared with 6.0 mg/dL for patients with unexplained anemia. Chronic kidney disease is an important cause of anemia in elderly persons, especially considering that renal function declines with aging. Reduced renal EPO production is the primary factor leading to anemia in chronic kidney disease. Conclusion. We describe a rare complication of severe hypothyroidism, pancytopenia, and its complete reversal after 1 month of thyroid hormone replacement. In cases of unexplained pancytopenia, hypothyroidism should be considered in the differential diagnosis. Upon arrival, she was experiencing bradycardia, hypothermia, and severe respiratory stridor. She did not report any chronic signs or symptoms of hypothyroidism. Past medical history was unremarkable; she was on no medications. Cirrhosis may be asymptomatic for years. One third of patients never develop symptoms. Often, the first symptoms are nonspecific; they include generalized fatigue (due to cytokine release), anorexia, malaise, and weight loss (see Common Symptoms and Signs Due to Complications of Cirrhosis). Cirrhosis is characterized by regenerating nodules and fibrosis. Incompletely formed liver nodules, nodules without fibrosis (nodular regenerative hyperplasia), and congenital hepatic fibrosis (ie, widespread fibrosis without regenerating nodules) are not true cirrhosis. Cirrhosis can be micronodular or macronodular. There are various methods of performing a differential diagnostic procedure, but in general, it is based on the idea that one begins by considering the most common diagnosis first: a head cold versus meningitis, for example. The differential diagnostic procedure may be simplified if a ' pathognomonic ' sign or symptom is found (in which case it is almost certain that the target condition is present) or in the absence of a sine qua non sign or symptom (in which case it is almost certain that the target condition is absent). Pancytopenia is a very important, serious comorbid condition commonly occurring among oncology patients, but it is often not specifically documented as such in the medical record. It is defined as suppression of all 3 bone marrow cell-lines resulting in simultaneous neutropenia, thrombocytopenia and anemia. Pancytopenia (and its cause) is always a significant diagnosis that affects severity of illness classification. It is considered most severe when due to chemotherapy or other drugs. Richard Pinson, MD, FACP, is a certified coding specialist and cofounder of HCQ Consulting in Houston. Anemia is strictly defined as a decrease in red blood cell (RBC) mass. The function of the RBC is to deliver oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs. This is accomplished by using hemoglobin (Hb), a tetramer protein composed of heme and globin. With anemia due to acute blood loss, a reduction in oxygen-carrying capacity occurs along with a decrease in intravascular volume, with resultant hypoxia and hypovolemia. Hypovolemia leads to hypotension, which is detected by stretch receptors in the carotid bulb, aortic arch, heart, and lungs. Often each individual option of a possible disease is called a differential diagnosis (for example, bronchitis could be a differential diagnosis in the evaluation of a cough that ends up with a final diagnosis of common cold). The differential diagnostic procedure may be simplified if a ' pathognomonic ' sign or symptom is found (in which case it is almost certain that the target condition is present) or in the absence of a sine qua non sign or symptom (in which case it is almost certain that the target condition is absent). Published by e-MedTools. e-Medtools is providing, as a public service, a free abbreviated list of DRG Modifiers that qualify as Major Complications and Comorbid Conditions (MCC) & Complications and Comorbid Conditions(CC) as defined by the Centers for Medicare & Medicaid (CMS). One important note: MCCs and CCs use terminology specific to the CMS, and MUST be documented by a healthcare practitioner, preferentially in the Discharge Summary. Medicare regulations prohibit Hospitals from providing this information to healthcare providers.
http://www.amjmed.com/article/S0002-9343(14)00454-9/fulltext https://en.wikipedia.org/wiki/Differential_diagnosis http://emedicine.medscape.com/article/1339998-overview http://www.amjmed.com/article/S0002-9343(14)00454-9/fulltext http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/fibrosis-and-cirrhosis/cirrhosis https://en.wikipedia.org/wiki/Differential_diagnosis http://www.acphospitalist.org/archives/2014/04/coding.htm http://emedicine.medscape.com/article/198475-overview https://en.wikipedia.org/wiki/Differential_diagnosis https://www.scribd.com/doc/49063853/CC-and-MCC-List-for-DRG-coding
is pancytopenia considered a comorbid