Bounce-back with black urine: A case report

A 33-year-old Congolese woman presented to our emergency department with a 2-month history of fatigue. Past medical history was significant for possible sickle cell trait, 2 uncomplicated pregnancies, total thyroidectomy for papillary thyroid cancer, bariatric surgery and previous transfusions due to micronutrient deficiencies. On investigation, she had microcytic anemia with a hemoglobin of 55 g/L, ascribed to iron and vitamin B12 deficiencies. She was administered intravenous iron, subcutaneous vitamin B12, transfused 4 units of red blood cells and discharged home with Hematology follow-up.