Hematology Case 1
Presented By Dr Mohammad Moharram
Released on 01-05-2019Patient Data
Female patient 38 y
Clinical Data
Chronic anemia, Bilateral lower limb pain, chest pain, back pain, pallor and palpitation.
Related Laboratory Results
HGB: 6.9 g/dL, HCT:21.4%,
MCV:79.3fL, MCH:25.6pg,
MCHC:32.2%,
Normoblasts:4/100wbc,
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)
Provisional Diagnosis
Sickle Cell Anemia
Case Picture(s) / Photo(s)
Comment / Findings
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%
Final Diagnosis
Homozygous Sickle Disease
Additional Note
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.