Hematology Case 1

Female patient 38 y

Reticulocytes: 7.7% ,

Absolute Reticulocytes: 202x10^9/L (R.R. 50-100) ,

Platelet: 38x10^3/uL, “ All the above parameters are by Sysmex XN3000”

Total Bilirubin:38.4umol/L(R.R.:3-17),

Direct Bilirubin: 1 umol/L (R.R.: 0-3)

Blood film show sickle cells , anisopoikilocytosis and normoblastemia

HGB electrophoresis by HPLC shows: HGB F: 8.9% , HGB A: 3, HGB A2: 3.4% HGB S: 78.8%

The patient is receiving treatment for sickle cell anemia that was diagnosed in another center 25 years ago.

3% of HGB which are measured at HGB A represent glycated HGB S. Some authors recommend to add them HGB S at reporting to avoid make conflict to the treating physician .

Reticulocytosis here is supposed to be represented by polychromasia. But bad staining hindered it.