Hematology Case 43
Hematology Case 43
Embedded Files
Presented By Dr Mohammad Moharram
Released on 4-11-2020Patient Data
Patient Data
54 year old male
Clinical Data
Clinical Data
Patient complain of Epigastric pain 10 days ago.
On Examination: Yellow sclera - Soft abdomen
U.S. Abdomen: No organomegaly or related abnormality.
Upper GIT endoscopy was done and biopsy was taken (See Histopathological result below).
Related Laboratory Results
Related Laboratory Results
CBC:
WBC: 8.2x103 /uL (Lymphocytes: 27% - Neutrophils: 63% - Monocytes: 5% - Eosinophils: 4% - Basophils: 1)
HGB: 9 G/dL - MCV: 114 fL - MCH: 37pG - MCHC: 32.5%
Platelet: 432 x103 /uL
Total Bilirubin: 74 umol/L (R.R.: 5.1-20.5)
Direct Bilirubin: 6 umol/L (R.R.: 1.7-8.6)
Normal RFT - Normal LFT
Serum Ferritin: 374 ng/ml (R.R.: 30-400) - Serum iron : 39 umol/L (R.R.: 8-32) - total Iron binding capacity: 42 umol/L (R.R.: 45-81).
Stomach biopsy form antrum antrum and body showed: Mild Chronic atrophic gastritis.
Case Picture(s) / Photo(s)
Case Picture(s) / Photo(s)
Comment / Findings
Comment / Findings
Macrocytic normochromic anemia
Marked RBCs anisocytosis and poikilocytosis.
Basophilic stippling of RBCs is seen.
Neutrophils show shift to Right
Final Diagnosis
Final Diagnosis
A case of Megaloblastic anemia. Vitamin B12 and folate assessment are recommended to confirm.
Additional Note
Additional Note
Vitamin B12 was done later. Its serum level was : 54 pg/ml (R.R.: 180-914) "Confirm the diagnosis)
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