A 69-year-old woman with hypothyroidism, alcoholic liver disease, coronary artery disease, ventricular arrhythmia requiring placement of an implantable cardioverter defibrillator, and end-stage renal disease on hemodialysis presented for evaluation of chronic anemia (hemoglobin level of 7-8 g/dL) with transfusion dependence. Notable medications include aspirin, amiodarone, warfarin, levothyroxine, and lansoprazole. Her vital signs were normal. Physical and neurological examinations yielded no abnormal findings.