A 39-year-old male from Maghreb, professional wrestler, with no family medical history, had been in perfect health until he developed muscular, back, and joints pain with fever and fatigue. The conjunctiva and the skin exhibited icterus; lumbar spine and knees were painful, and muscles were markedly tender. No other abnormalities were found during the examination. He had a regenerative anaemia (haemoglobin, 79 g/L; reticulocytes, 145 giga/L) with microcytosis (mean corpuscular volume, 72 fL), and mild thrombocytopenia (platelets, 110 3 109/L). The white blood cell count was 30,280/mm 3 with 21,500/ mm3 neutrophils and myelemia. The peripheral blood smear showed anisopoikilocytosis and target cells; schistocytes or sickle cells were absent. Total bilirubin was 56 Image 1. Whole body MRI using ''fluid sensitive'' STIR sequences (Short Tau Inversion Reconvery) without gadolinium showing diffuse hyperintense involvement of the bone marrow spine (a and c) (even spinous process, c) and pelvic lesions (sacrum, ilium, ischium) with sharp margins and serpentine borders in favor of bone infarcts. There is also vertebral body endplate collapse.
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