Simple measures to prevent a massive upper gastrointestinal bleed.

Nasogastric (NG) tube is frequently used in clinical practice for a variety of indications; however, NG tubes are not without risks, and there are a multitude of gastrointestinal complications that are associated with their use. Simple precautions can help prevent these NG tube-related injuries.

"Irony" of managing refractory anemia with transfusional support in hemophagocytic lymphohistiocytosis.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening derangement of the immune system in which host macrophages phagocytose the patient's own blood cells. Herein, we present the case of a patient with HLH and associated refractory anemia who developed rapid iron deposition in the liver after transfusion of sixteen units of packed red blood cells (RBCs). Before transfusion, neither a liver biopsy nor computed tomography scan demonstrated iron deposition in the organ parenchyma. After receiving sixteen units of packed RBCs, liver iron concentration rose to 6.7 mg/g dry weight, which is highly unusual in other diseases requiring transfusional support.