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"Case 4"
  • Case 4


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Case 4
  • History:
  • 37 year old male.
  • Lifelong history of a seizure disorder, treated since age two.
  • At a routine check with his neurologist, he complained of fatigue, exertional dyspnea, and lightheadedness over the past 2-3 months.
  • He appeared pale, but otherwise his physical exam was within normal limits. He was found to have a decreased hemoglobin, and was referred to Hematology Clinic
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CBC
  • RBC 1.26 x 10[12]/L
  • HGB 5.7 g/dL
  • HCT 16.3 %
  • MCV 130 fL
  • MCH 45.2 pg
  • MCHC 34.9 g/dL
  • RDW 18.1
  • WBC 6.2 x 10[9]/L ) N 73 % , L 21, M 1, E 4 , B 1)
  • PLT 219 x 10[9]/L
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"Question"


  • Questions
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What morphologic alterations are seen in this blood smear field?
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What further laboratory studies, if any, are indicated?
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What is the most likely diagnosis?