Blue rubber bleb nevus syndrome.

A 61-year-old woman who had hypertension and diabetes presented to the gastroenterology clinic with profound fatigue and malaise of about 6 months’ duration. She denied any chest pain, shortness of breath, hematochezia, melena, hematemesis, or constitutional symptoms. The patient reported no new prescriptions, over-the-counter medications, or herbal supplements. She said that a screening colonoscopy 10 years earlier had been “normal.”