Random cases

Question 1

Raised RDW. Mildly low Hb

• Blood film: Spherocytes, Howell-Jolly bodies, polychromatic cells
• What is the most likely diagnosis?

Answer 1

-Hereditary Spherocytosis

Question 2

• Low Hb, Raised reticulocytes
  - Raised WBC
  - Blood film: red cell fragments, schistocytes, Heinz Bodies, bite cells
  - What is the most likely diagnosis?

Answer 2

-G6PD deficiency

Question 3

• Raised bilirubin, Raised ALT, Low Hb
  - Raised RDW
  - Coomb’s test -ve
  - Blood film: anisocytosis, spherocytes, bite cells, polychromatic cells.
  - What is the most likely diagnosis?

Answer 3

-Dapsone induced haemolysis (or just drug induced)
			//Bite cells: think oxidative haemolysis

Question 4

• Blood count of a child aged 18 months:
• RBC 5.57 x10^12/l
• Hb 105 g/l
• Hct 0.326 l/l
• MCV 58 fl
• MCH 18.9 pg
• MCHC 323 g/l
• Cellulose electrophoresis: band in the A position, band in the C position (Roughly 90%:10% ratio)
• What is the diagnosis?

Answer 4

-Beta thal trait

Question 5

• HPLC of an adult afro-caribbean:
• F peak: 3.3%
• HbA: 2.6%
• HbA2: 4.3%
• S-window: 89.1%
• Cellulose electrophoresis: Band in the S position: Nearly 100%
• Acid agarose electrophoresis: band in the C position
• What is the most likely diagnosis?

Answer 5

-HbSC

Question 6

• Adult afro-caribbean HPLC
  - HbF: 0.7%
  - HbA: 55.7%
  - HbA2: 3.63%
  - S-window: 1.8%
  - C-window: 32.6%
  - What is the most likely diagnosis?

Answer 6

-HbC trait

Question 7

Afro-Carribean man has Burkitt’s lymphoma and before surgery is given Rubaricase to prevent renal failure. Shortly after he becomes unwell: pallor, shortness of breath, jaundice and his Hb drops from 120g/L to 56 g/L.
Blood Film with hemighosts and bite cells
What is most likely diagnosis?

Answer 7

Unanswered*