Hematology Case 12
Presented By Dr Mohammad Moharram
Released on 01-05-2019Patient Data
46 year old Female
Clinical Data
Recurrent Epistaxis (2 times ; Mild & controllable)
Mild to moderate thrombocytopenia in all previous CBC.
Clinician requested blood smear.
Related Laboratory Results
WBC: 4.2X10³/uL
HGB: 11.6 G/dL
MCV: 79 fL MCH: 23 PG
MCHC: 29.1 %
PLATELET: 55X10³/uL.
Bleeding time: 5 min.
PT: 11.5 sec (INR: 1)
APTT: 25 (R.R.: 25-36)
Normal RFT, LFT and fasting Blood sugar
Platelet functions : Not available in our center.
Provisional Diagnosis
Platelet function disorder
Case Picture(s) / Photo(s)
Comment / Findings
Neutrophils show basophilic cytoplasmic inclusions ; resembling Dohle bodies.
Moderate thrombocytopenia; giant platelets are frequantly seen.
Mild microcytic hypochromic anemia with anisocytosis.
Final Diagnosis
Picture is highly suggestive of May-Hegglin anomaly (to be confirmed by molecular study: MYH9 gene mutation)
Additional Note
Patient is advised to be referred to specialized center but she refused.
The case is associated with iron defeciency as confirmed by iron profile.