Hematology Case 56
Hematology Case 56
Embedded Files
Patient Data
Patient Data
15 year old female
Clinical Data
Clinical Data
History & Complain: Heavy menses 1 week ago - Dizziness and palpitation 2 days ago - Easy fatigability.
Examination: Pallor with no jaundice - Blood pressure 135/65 - Pulse 110 b/m.
Abdominal Ultrasound: No abnormal findings
Related Laboratory Results
Related Laboratory Results
CBC:
- WBC: 2.3x103 /uL (Neutrophils: 0.3x103 /uL - Lymphocytes: 1.9x103 /uL - Monocytes: 0.05x103 /uL - Eosinophils: 0.04x103 /uL - Basophils: 0x103 /uL).
- HGB: 6.9 g/dL (4.5 before blood transfusion)- MCV:74 fL -MCH: 23.7pG - MCHC: 32%
- Platelet: 22x103 /uL
Amylase: u/L (R.R.: 25-115) - Lipase : u/L (73-393).
Normal RFT & LFT
LDH: 124 u/L (R.R.: 98-192)
Serum Iron: 41 umol/L (5-30.5) - Serum Ferritin: 22 ng/mL (R.R.: 13-150)
Vitamin B12: 475 pg/mL (R.R.: 180-914) - Serum folate: 43 nmol/L (R.R.: 7-45).
Antinuclear antibodies: Positive - Anti-ds DNA (IgG): Positive
Case Picture(s) / Photo(s)
Case Picture(s) / Photo(s)
Images Comment / Findings
Images Comment / Findings
Bone marrow aspirate:
Hypocellular bone marrow; decreased all marrow elements (Myeloid , erythroid and megakaryocytic) with relative increase in lymphocytes and plasma cells (secondary to B.M. elements depression).
Bone marrow trephine biopsy:
Hypocellular Bone marrow for age. Estimated cellularity is <20%. All bone marrow elements are decreased. Megakaryocytes are not seen and few residual clusters of erythroid precursors are noted. The intertrabecular spaces are replaced by fat.
Final Diagnosis
Final Diagnosis
Hypoplastic / aplastic pancytopenia, mostly of immune related. Furhter immunological investigations are recommended.
Additional Note
Additional Note
The case was referred to a higher center for further investigations and cytogenetic studies.
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