25 June 2020 (Thursday) - Iron Deficient ALL

Here's an interesting case. In all the furore of seeing circulating blast cells in a two year old it is easy to overlook the underlying iron deficiency.

This really underscores the importance of thorough blood film scrutiny of all three cell lines

HITLER Edward Elizabeth        M654321           30.02.18 F R,20.3079135.J       R 25.06.20  Clinical details limping child, fever ?ALL --------------------------------------------------------------------------------             HBM   WBCM    PLT    HCT   RBCM   MCVM   MCHM  MCHCM    RDW      N 230620 F     94  23.85     88  0.293   4.79   61.2   19.6    321   20.7   1.99 240620 F     90  28.33     86  0.290   4.63   62.6   19.4    310   20.7   2.11 240620 F     85  19.43     76  0.267   4.31   61.9   19.7    318   20.3     NA 250620 F     75  13.78     67  0.235   3.81   61.7   19.7    319   20.0     NA               L      M      E      B   NRBC    ESR     GF 230620 F     NA     NA   0.16   0.08   0.06              240620 F     NA     NA   0.15   0.08   0.05              240620 F     NA     NA     NA     NA   0.03              250620 F     NA     NA     NA     NA   0.03              --------------------------------------------------------------------------------   WBCM MNEUT MLYMP MMONO  MEOS MBASO  META MYELO  PROM BLAST  NRBC         (3)   (2)   (1)   (4)   (5)   (6)   (7)   (8)   (9)  #(0)  103    13    83     0     0     0     0     1     0     6     0   13.8   1.7  11.1   0.0   0.0   0.0   0.0   0.1   0.0   0.8   0.0 couNt/dIrect/Diffs/Comms/Add comms/Hold/Rel/aBandon/reJect <R> .