Here’s an interesting case that came up today…(for those not familiar with the display, the bottom results are the current, and those above the previous)
The results
show that the patient is anaemic. I’d expect hypochromia given these results,
but target cells and pencil cells too?
KIRK JAMES T
M1234567 01.04.44 Dr McCoy
H,22.7654321.A R 25.11.22
Clin. det.
DIFF Blood Film Review
Diagnosis
--------------------------------------------------------------------------------
HBM
WBCM PLT HCT RBCM MCVM
MCHM MCHCM RDW N
310122 145 8.91
218 0.454 4.51 100.7 32.2 319
13.0 5.52
050322 135 9.28
210 0.418 4.23 98.8 31.9 323
13.9 5.92
080422 132 6.96
289 0.418 4.15 100.7 31.8 316
13.6 3.69
251122 F 72 8.04
292 0.246 2.95 83.4 24.4 293
16.2 4.36
L
M E B RETP
RETA IRF NUC GF ESR
310122 2.32 0.80 0.23
0.04
050322 2.40 0.76 0.16
0.04
080422 2.28 0.77 0.19
0.03
251122 F 2.49 0.89 0.24
0.06 1.8 54.90 28.9
Iron
deficient anaemia??? The patient had a
very low ferritin. But look at the MCV from nearly a year ago… Given that the
patient runs an MCV of about a hundred, the MCV is currently running at only
eighty percent of what it was. Perhaps not microcytic in absolute terms, but consider
how they have changed.
As Albert
once said, “everything’s relative”
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