{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:33:13Z","timestamp":1760189593492,"version":"3.40.4"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,11,27]]},"abstract":"<jats:p>This case report describes mild anaemia and intravascular haemolysis in an otherwise healthy 41-year-old ultramarathon runner. In long-distance endurance athletes, trace gastrointestinal bleeding and plasma volume expansion are recognised sources of mild anaemia, often found incidentally. However, repetitive forceful foot striking can lead to blood cell lysis in the feet, resulting in a mild macrocytic anaemia and intravascular haemolysis, as was demonstrated in the patient described herein. Mild anaemia in runners, often called \u2018runner\u2019s pseudoanaemia\u2019, is typically clinically insignificant and does not require intervention. However, an unexplained anaemia can cause undue worry for otherwise healthy patients and lead to costly further testing, providing an argument against routine testing with complete blood counts in healthy, asymptomatic patients.<\/jats:p>","DOI":"10.1136\/bcr-2017-220661","type":"journal-article","created":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T11:25:21Z","timestamp":1513164321000},"page":"bcr-2017-220661","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Foot-strike haemolysis in an ultramarathon runner"],"prefix":"10.1136","volume":"2017","author":[{"given":"Abid A","family":"Fazal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary S","family":"Whittemore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharine C","family":"DeGeorge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,12,13]]},"reference":[{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01296524"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.2","doi-asserted-by":"publisher","DOI":"10.3109\/00365528609015168"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.3","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1249\/00005768-199112000-00004","article-title":"Blood volume: its adaptation to endurance training","volume":"23","author":"Convertino","year":"1991","journal-title":"Med Sci Sports Exerc"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2005.05.021"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.5","first-page":"241","article-title":"La cholamae simple familiale","volume":"21","author":"Gilbert","year":"1901","journal-title":"Sem Med"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.6","first-page":"140","article-title":"Study of the etiology and pathogenesis of low grade nonhemolytic unconjugated hyperbilirubinemia (Gilbert\u2019s disease)","volume":"24","author":"Blueger","year":"1977","journal-title":"Acta Hepatogastroenterol"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.7","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1182\/blood.V57.6.983.983","article-title":"Quantitative aspects of bilirubin metabolism for hematologists","volume":"57","author":"Berlin","year":"1981","journal-title":"Blood"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.8","doi-asserted-by":"publisher","DOI":"10.1080\/15216540500380871"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.9","first-page":"691","article-title":"Ueber eine neue form von haemoglobinurie beim menschen","volume":"18","author":"Fleischer","year":"1881","journal-title":"Berl Klin Wochenschr"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.10","doi-asserted-by":"publisher","DOI":"10.1001\/jama.286.6.714"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.11","first-page":"377","article-title":"Foot-strike haemolysis after a 60-km ultramarathon","volume":"10","author":"Lippi","year":"2012","journal-title":"Blood Transfus"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.12","first-page":"81","article-title":"Iron metabolism in reticuloendothelial cells","volume":"20","author":"Deiss","year":"1983","journal-title":"Semin Hematol"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.13","doi-asserted-by":"publisher","DOI":"10.1007\/s004210050502"},{"key":"2025042713143961000_2017.dec12_1.bcr-2017-220661.14","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1055\/s-2007-1024692","article-title":"Development of runner\u2019s anemia during a 20-day road race: effect of iron supplements","volume":"12","author":"Dressendorfer","year":"1991","journal-title":"Int J Sports Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220661","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T20:14:51Z","timestamp":1745784891000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220661"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,13]]},"references-count":14,"alternative-id":["10.1136\/bcr-2017-220661"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220661","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,12,13]]}}}