[Severe anemia and chronic alcohol abuse lacking signs of gastrointestinal bleeding in a 40-year-old].

We report about a 40 year old patient presenting a severe anemia caused by a folate deficiency combined with chronic alcohol abuse and probable liver cirrhosis. Besides pathophysiology and etiology of folate deficiency the correlation of malnutrition and liver cirrhosis (in particular caused by alcohol abuse) is discussed. As a conclusion for clinical practice the necessity of an extensive investigation for causes of an existing anemia, even in cases, which very much seem to be caused by an acute bleeding event, shall be demonstrated. Furthermore this report shows the importance of a consistent nutrition counseling of patients with liver cirrhosis.