Presented to the emergency department, reporting dyspnea, edema of the lower limbs, asthenia, and adynamia. At the physical examination, he was obtunded and had bibasal rales. On laboratory tests, acute chronic renal failure and anemic syndrome of normal volumes were demonstrated. On arterial gases, hypoxemia (pO2: 65 mm Hg) and hypocapnia (pCO2: 29 mm Hg) was found. On an endoscopic study of the digestive tract, no lesion was found that will explain the anemic syndrome. An echocardiogram T.T. reported mild concentric LV hypertrophy with normal systolic function: 60%.