Hematology Case Study A - History: A 6-year-old male is admitted

MEDT 4600 Hematology Review

Case Study A

History: A 6-year-old male is admitted to the hospital for a work up for juvenile-on-set diabetes mellitus. He was also being treated for a macrocytic anemia.

Lab results were:

WBC 2.9 (x10 9 /L)

RBC 2.53 (x10 12

/L) HGB 10.2 (g/dL)

HCT 29.3 (%)

MCV 116.0 fL

MCH 40.6 (pg)

MCHC 34.2 (%)

RDW 18.1 (%)

PLT 76 (x10 9 /L)

Retic 0.4%

Question 1 – What is the most likely diagnosis based on the lab results above?

Additional testing:

Bone Marrow:

Decreased M:E ratio

3% Blasts

2

Peripheral Blood Smear:

Macrocytic RBCs

Low platelet count

Hyposegmented neutrophils

Treatment

Patient was given vitamin B12 for 6 weeks– no change in the anemia status (patient did not respond to treatment)

Question 2 – Does our patient have megaloblastic anemia? Why or why not?

Question 3 – Looking at ALL the lab results again, what is another possible diagnosis for this patient?

Patient Outcome

Patient was given supportive therapy for 4 years (packed red blood cells and platelets). Patient died of overwhelming infections