42/F known ISS on ART with severe anaemia

Case Presentation

42/F known ISS on ART for 4 years with severe anemia, hematemesis, hematochezia plus melena stools. She had similar episodes before with h/o transfusion, and has had the oral lesions for more than 20 years. No other skin lesions O/E: wasted, severe parlor, Jº, Eº, Lº kiolonychia PA: diffuse tenderness more in the epigastrium, no masses palpable Reported one of family members with similar lesions No Family hx of cancer.