Case Study (7)- Hemolytic anemia of unknown origin with thrombocytopenia.
History:
The diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) was established 40 years ago. Since then a splenectomy was performed. The 51-year-old man is periodically assessed.
Blood was taken as a part of his routine checkups. Currently, he complains about fatigue and mild dyspnea. Occasionally he experiences a brownish discoloration of the urine.
Laboratory Investigations:
1. CBC:
RBC:3.26 X 106/μL (4-5.5 X 106/μL)
HGB: 70 g/dL (120-174 g/dL)
HCT: 23.8% (36-52%)
MCV: 73.1 fL (76–96 fL)
MCH: 21.6 pg (27-32 pg)
MCHC: 295 g/L (300-350 g/L)
RDWsd:49.9 fL (20-42 fL)
RDWcv: 23.3% (0-16 %)
WBC: 5.48 X103/ μL (5–10 X 103/ μL)
Neutrophils: 1.86 X 103/μL (2-7.5 X 103/μL)
Lymphocytes: 2.44 X 103/μL (1.08–3.17 X 103/μL)
Monocytes: 1.03 X 103/μL (0.15-0.7 X 103/μL)
Eosinophils: 0.04 X 103/μL (0-0.5 X 103/μL)
Basophils: 0.11 X 103/μL (0-0.15 X 103/μL)
Neutrophils %: 33.9 % (40-75 %)
Lymphocytes %: 44.6 % (14.76-45.4 %)
Monocytes %: 18.8 % (3-7 %)
Eosinophils %: 0.7 % (0-5 %)
Basophils %: 2 % (0-1.5 %)
PLT: 102 X 103/μL (150-400 X 103/μL)
Peripheral blood smear
2. Other laboratory findings
- The reticulocyte count is 6%.
- The serum total bilirubin level is 46 μmol/L [ref range: 0-21 μmol/L]).
- while the lactate dehydrogenase activity is (4520 U/l [ref range: 230-460 U/L]).
- There are no further abnormalities in other laboratory test results.
Diagnosis
Hemolytic anemia of unknown origin with thrombocytopenia.
Disease course
- The initiation of specific biological therapy is considered.
- Hemolytic anemia of unknown origin with thrombocytopenia. History: The diagnosis of paroxysmal nocturnal hemoglobinuria …){kind=link}
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