Cerebral venous thrombosis (CVT) has been associated with numerous etiologies and a myriad of symptoms. Although CVT in association with iron deficiency anemia (IDA) has been observed primarily in pediatric patients, very few cases have been reported in adults. Herein, we describe an encounter with a 28 year-old female who presented solely with a new onset headache due to transverse sinus thrombosis. Thrombophilia work-up was normal. She had no identifiable acquired causes of thrombosis. The patient demonstrated severe iron deficiency anemia secondary to myoma uteri causing menorrhagia.

Herein, we report a case where agranulocytosis occurred after spironolactone administration. Patient presented with non-descript constitutional symptoms suggestive of a viral etiology associated to new onset agranulocytosis with neutrophilic maturation arrest on bone marrow biopsy. Patient’s medical history included chronic liver disease as well as new onset acute renal insufficiency. Upon review of patient’s medications, initiation of spironolactone was noted 4 weeks prior to admission. Few cases of agranulocytosis secondary to spironolactone have been reported in the literature, most of which were also in association with both renal insufficiency and chronic liver disease. Discontinuation of spironolactone resulted in normalization of granulocyte count within 3 weeks. As patients with chronic liver disease are frequently given spironolactone, we recommend monitoring blood counts 4 - 8 weeks following initiation of therapy to detect and treat this potentially life threatening complication.