An
interesting finding on an admission to the A&E department
K0123456
Burnham MICHAEL 01.02.03
M Accident & Emer
Specimen R,18.0006197.A Clin
dets fall, tender left hip and l3-l5 fracture
Collected 15.01.18 NK
A.Diag
-------------- high intensity test code =>
unauthorised result -------------
PT 11.5
|RDW + 29.5
|
APTT 29.0
|Neuts NA
|NRBC's 2.5
FIB + 6.99
|Lymphs NA
|NUCA 0.27
Hb - 82
|Monos NA
|
WBC + 10.66
|Eosin NA
|
Plts 327
|Baso NA
|
Hct - 0.288
|FILM Film Made
|
RBC - 2.79
|MNEUT + 9.63a
|
MCV + 103.2
|MLYMP - 0.69a
|
MCH 29.4
|MMONO 0.34a
|
MCHC - 285
|
|
|
Turns out the
patient has had a splenectomy in the past. To quote an
on-line source:
“In our consult experience misinterpretation
of the blood smear findings in the splenectomized patient is a cause of
significant misdiagnosis.The blood changes following splenectomy are relatively
predictable and knowing these changes can obviate a wrong diagnosis and therapy
in your patient.”
How true…
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