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Auto-immune Hemolytic Anemia


This patient was a 76 year old man with a history of chronic lymphocytic leukemia, initially diagnosed 2 years ago. Over the past three weeks the patient had noted progressive fatigue and shortness of breath with exertion. Laboratory examination showed a severe anemia and a disproportionately low RBC count. MCV was strongly increased, due to the massive reticulocytosis (see case 36). Morphology showed numerous spherocytes as well as polychromatic macrocytic erythrocytes. Additional studies revealed 35 % reticulocytosis, an elevated LDH (960 IU/L), and a positive direct Coomb’s test.

Numerical Results

WBC 10e3/μL
NEU 3.436 30.522 %
BLST 0.01 .010 %
MONe .448 3.98 %
EOS .062 .553 %
BASO .109 .965 %
LYMe 7.20 63.985 %  VARLYM

RBC 1.78 10e6/μL
HGB 8.09 g/dL
HCT 22.3 %
MCV 125. fL
MCH 45.4 pg
MCHC 36.3 g/dL
RDW 22.2 %

PLT 244. 10e3/μL
MPV 6.84 fL

CELL-DYN Ruby Casebook. Auto-immune Hemolytic Anemia. 2018. ADD-00005070. p.34
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