Low back pain in young women: an unusual case.

This is a case of a 28-year-old woman from Syria who was admitted to the Rheumatology Unit of the University of Padua Medical Center, Italy, because of severe low back pain (LBP). Laboratory investigations were performed to define the diagnose. The magnetic resonance (MR) images showing bone marrow involvement, could be suggestive of acute infarction. The hyperpyrexia, the elevation of LDH, ALP, AST and ALT levels, the reduction in the aptoglobina, the hyperbilirubinemia, noted at the 5th day of hospitalization, were suggestive of hemolitic anemia. The suspicion led us to evaluate the haemoglobin electrophoresis and the sickle cell plus beta (HbS/?+)-thalassemia became evident. This case emphasizes the importance of maintaining a broad differential diagnosis for a diffuse musculoskeletal disorder such as LBP. Therefore, in this case report, the clinical and instrumental data together with the laboratory investigations were useful to define the undiagnosed mild HbS/?+ thalassemia in geographic areas without newborn screening.