A laboratory evaluation revealed a low hemoglobin level of 9.4 g/dL (normal, 11.0-15.0 g/dL). His erythrocyte sedimentation rate was 60 mm/h (normal, ≤15 mm/h), and his total leukocyte count was 9000/μL (normal, 4000/μL-11 000/μL). (To convert hemoglobin to grams per liter, multiply by 10; and to convert total leukocyte count to numeral times 109 per liter, multiply by 0.001.) The result of the enzyme-linked immunosorbent assay for human immunodeficiency virus infection was negative. The result of chest radiography was normal.