Case Presentation: This patient is a 34 year old female presenting to the ED complaining of progressive weakness,SOB, bloody vomitus, and tarry stool. She had PMH significant for established diagnosis of Bean Syndrome. On presentation she was normotensive, 113/72mmHg but tachycardic 102. Labs revealed acute microcytic anemia H/H 6.7/23.6 MVC 70.9 prior to transfusion. She [...]